Reabsorción condilar poscirugía ortognática. Revisión de la literatura

Abstract

Objective

Condylar resorption has been described as a possible complication of orthognathic surgery. In this condition, condyles are partially or completely reabsorbed, with a consequent shortening of condylar height and an alteration in maxillofacial morphology and occlusion. The aim of this review was to clarify risk factors for condylar resorption, its diagnosis and the treatments used, and to design a protocol for the prevention of post-orthognathic surgery condylar resorption (POCR).

Materials and methods

Studies related to POCR published between 1990 and 2011 were identified and reviewed in the following databases: PubMed, MedLine, EMBASE, TESEO and Cochrane. The key words used were orthognathic surgery, condylar resorption, condylar atrophy, dysfunctional remodeling and condylysis. A manual search was carried out to identify other possible studies.

Results

The main risk factors associated with POCR were dolichofacial growth pattern, small or posteriorly inclined condyles, disk displacement, being female, hormonal disorders, and compression or postsurgical condylar torque. Proposed treatments consisted of stabilizing condylar position and decreasing condylar loading; improving fibrocartilaginous homeostasis with drug therapy, infiltrations or arthrocentesis; and temporomandibular joint surgery (arthroscopy, condylar revascularization, discal reposition, condylectomy and autogenic or alloplastic reconstruction).

Conclusions

POCR is a complex condition and a highly controversial issue, as reflected in the numerous articles published.