M A Mokhirev, K F Abdullaev, D A Volchek, Z I Kulumbegov, E I Ermolina
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The analysis included a comparison of MC volumes between T<sub>1</sub> and T<sub>2</sub>, as well as T<sub>1</sub>-T<sub>2</sub> distance measurements on the apexes of five surfaces (superior, anterior, posterior, medial, and lateral). The relationship between changes in MC volumes and the surgical intervention characteristics (maxillomandibular advancement (MMA) and the degree of mandibular occlusal plane rotation (CCWR)) was also assessed.</p><p><strong>Results: </strong>The mean MC volume before surgery was 2142.13±427.88 mm³ (95% CI 1987.86 mm³ to 2296.39 mm³), and after surgery, it was 2141.53±540.51 mm³ (95% CI 1946.66 mm³ to 2336.41 mm³). No significant differences were found between MC volumes before and after surgery (<i>T</i>-test=0.0103; <i>p</i>=0.9918; Wilcoxon test=251.0; <i>p</i>=0.8177). T<sub>1</sub>-T<sub>2</sub> changes demonstrated minimal remodeling across all MC surfaces, with no significant differences observed between surface pairs (M<sub>T1-T2</sub>=0.02±0.38 mm, Kruskal-Wallis test=0.523, <i>p</i>=0.971; ANOVA =0.294, <i>p</i>=0.882). No correlations were identified between changes in MC volume and the characteristics of surgical intervention (<i>r</i>=-0.026 (<i>p</i>=0.888) for MMA, <i>r</i>=-0.07 (<i>p</i>=0.704) for CCWR). Clinically significant symptoms in the temporomandibular joint (TMJ) or instability in mandibular position at T<sub>2</sub> were not observed.</p><p><strong>Conclusion: </strong>Morphological changes in the MC following bimaxillary orthognathic surgery in patients with skeletal Class III malocclusion fall within the parameters of functional remodeling. These changes are accompanied by mandibular stability and do not lead to TMJ dysfunction in the late postoperative period.</p>","PeriodicalId":35887,"journal":{"name":"Stomatologiya","volume":"104 4","pages":"66-72"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Functional remodeling of the mandibular condylar process after bimaxillary orthognathic surgery in patients with skeletal class III malocclusion].\",\"authors\":\"M A Mokhirev, K F Abdullaev, D A Volchek, Z I Kulumbegov, E I Ermolina\",\"doi\":\"10.17116/stomat202510404166\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate morphological changes in the mandibular condyle (MC) during its remodeling following bimaxillary orthognathic surgery in patients with skeletal class III malocclusion.</p><p><strong>Material and methods: </strong>İn this study 32 three-dimensional virtual models of the condylar process of the mandible from 16 patients with skeletal class III malocclusion have been analyzed. The models were generated from computed tomography scans performed one week before (T<sub>1</sub>) and 12 months after (T<sub>2</sub>) bimaxillary orthognathic surgery. The analysis included a comparison of MC volumes between T<sub>1</sub> and T<sub>2</sub>, as well as T<sub>1</sub>-T<sub>2</sub> distance measurements on the apexes of five surfaces (superior, anterior, posterior, medial, and lateral). The relationship between changes in MC volumes and the surgical intervention characteristics (maxillomandibular advancement (MMA) and the degree of mandibular occlusal plane rotation (CCWR)) was also assessed.</p><p><strong>Results: </strong>The mean MC volume before surgery was 2142.13±427.88 mm³ (95% CI 1987.86 mm³ to 2296.39 mm³), and after surgery, it was 2141.53±540.51 mm³ (95% CI 1946.66 mm³ to 2336.41 mm³). No significant differences were found between MC volumes before and after surgery (<i>T</i>-test=0.0103; <i>p</i>=0.9918; Wilcoxon test=251.0; <i>p</i>=0.8177). T<sub>1</sub>-T<sub>2</sub> changes demonstrated minimal remodeling across all MC surfaces, with no significant differences observed between surface pairs (M<sub>T1-T2</sub>=0.02±0.38 mm, Kruskal-Wallis test=0.523, <i>p</i>=0.971; ANOVA =0.294, <i>p</i>=0.882). No correlations were identified between changes in MC volume and the characteristics of surgical intervention (<i>r</i>=-0.026 (<i>p</i>=0.888) for MMA, <i>r</i>=-0.07 (<i>p</i>=0.704) for CCWR). Clinically significant symptoms in the temporomandibular joint (TMJ) or instability in mandibular position at T<sub>2</sub> were not observed.</p><p><strong>Conclusion: </strong>Morphological changes in the MC following bimaxillary orthognathic surgery in patients with skeletal Class III malocclusion fall within the parameters of functional remodeling. 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引用次数: 0
摘要
目的：探讨骨型III型错颌患者行双颌正颌手术后下颌髁突（MC）重塑过程中的形态学变化。材料与方法：İn本研究对16例骨骼III类错颌患者的32个下颌骨髁突三维虚拟模型进行了分析。这些模型是通过双颌正颌手术前一周和术后12个月的计算机断层扫描生成的。分析包括比较T1和T2之间的MC体积，以及五个表面（上、前、后、内、外侧）顶点的T1-T2距离测量。我们还评估了MC体积的变化与手术干预特征（上颌下颌前移（MMA）和下颌咬合平面旋转程度（CCWR））之间的关系。结果：术前平均MC体积为2142.13±427.88 mm³（95% CI 1987.86 mm³~ 2296.39 mm³），术后平均MC体积为2141.53±540.51 mm³（95% CI 1946.66 mm³~ 2336.41 mm³）。手术前后MC体积差异无统计学意义（t检验=0.0103;p=0.9918； Wilcoxon检验=251.0;p=0.8177）。所有MC表面T1-T2变化均表现出最小的重构，表面对之间无显著差异（MT1-T2=0.02±0.38 mm， Kruskal-Wallis检验=0.523,p=0.971；方差分析=0.294,p=0.882）。MC体积的变化与手术干预的特征没有相关性(MMA的r=-0.026 （p=0.888)， CCWR的r=-0.07 (p=0.704)）。未观察到颞下颌关节（TMJ）的临床显著症状或T2时下颌位置不稳定。结论：骨性ⅲ类错颌患者行双颌正颌手术后MC形态改变符合功能重塑参数。这些变化伴随着下颌稳定，在术后后期不会导致颞下颌关节功能障碍。
[Functional remodeling of the mandibular condylar process after bimaxillary orthognathic surgery in patients with skeletal class III malocclusion].
Objective: To evaluate morphological changes in the mandibular condyle (MC) during its remodeling following bimaxillary orthognathic surgery in patients with skeletal class III malocclusion.
Material and methods: İn this study 32 three-dimensional virtual models of the condylar process of the mandible from 16 patients with skeletal class III malocclusion have been analyzed. The models were generated from computed tomography scans performed one week before (T1) and 12 months after (T2) bimaxillary orthognathic surgery. The analysis included a comparison of MC volumes between T1 and T2, as well as T1-T2 distance measurements on the apexes of five surfaces (superior, anterior, posterior, medial, and lateral). The relationship between changes in MC volumes and the surgical intervention characteristics (maxillomandibular advancement (MMA) and the degree of mandibular occlusal plane rotation (CCWR)) was also assessed.
Results: The mean MC volume before surgery was 2142.13±427.88 mm³ (95% CI 1987.86 mm³ to 2296.39 mm³), and after surgery, it was 2141.53±540.51 mm³ (95% CI 1946.66 mm³ to 2336.41 mm³). No significant differences were found between MC volumes before and after surgery (T-test=0.0103; p=0.9918; Wilcoxon test=251.0; p=0.8177). T1-T2 changes demonstrated minimal remodeling across all MC surfaces, with no significant differences observed between surface pairs (MT1-T2=0.02±0.38 mm, Kruskal-Wallis test=0.523, p=0.971; ANOVA =0.294, p=0.882). No correlations were identified between changes in MC volume and the characteristics of surgical intervention (r=-0.026 (p=0.888) for MMA, r=-0.07 (p=0.704) for CCWR). Clinically significant symptoms in the temporomandibular joint (TMJ) or instability in mandibular position at T2 were not observed.
Conclusion: Morphological changes in the MC following bimaxillary orthognathic surgery in patients with skeletal Class III malocclusion fall within the parameters of functional remodeling. These changes are accompanied by mandibular stability and do not lead to TMJ dysfunction in the late postoperative period.
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