Anterior mandibular distraction osteogenesis: a retrospective study of condylar stability in the treatment of mandibular retrognathia secondary to idiopathic condylar resorption

Abstract

Introduction

The etiology of idiopathic condylar resorption (ICR) is not conclusively established, and its treatment is primarily focused on correcting secondary maxillofacial deformities. Condylar resorption is a common complication of the treatment of ICR. As one treatment for mandibular retrognathia secondary to idiopathic condylar resorption (MRSICR), distraction osteogenesis (DO) can improve the facial profile and the occlusion. However, it has not been accurately determined whether DO could cause damage to the condyle. In this experiment, one innovative therapeutic modality was used to treat MRSICR by changing the traction device from the traditional posterior position of the mandibular body to the premolar region to explore a treatment method with less impact on the temporomandibular joint area (TMJ).

Materials and methods

A total of 11 patients (22 condyles) were included. To simulate the direction of traction, preoperative digital design was performed. Patients' radiological data were collected preoperatively (T0), six months following surgery (T1), a year following surgery (T2), and three years following surgery (T3). The changes in the distance of the TMJ space and in the surface area, volume, condylar plane angle, and condylar height at different intervals were assessed.

Results

Surface area, volume, height and the distances of anterior and posterior joint spaces of the condyle did not alter significantly after surgery (P > 0.05). Significant differences were found in the postoperative changes in supra-joint space and the condylar displacement in cross-section (P < 0.05).

Discussion

Our study suggests that as a treatment for MRSICR, the DO of the anterior mandible has shown some advantages in avoiding postoperative complications as condylar resorption. Larger sample sizes are required for future research to validate the viability of this technique.