Improvement of the temporomandibular joint symptoms due to the condylar position change following modified L-shaped intraoral vertico-sagittal ramus osteotomy: a single-center, retrospective study.

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Oral and Maxillofacial Surgery-Heidelberg Pub Date : 2024-09-01 Epub Date: 2024-06-17 DOI:10.1007/s10006-024-01266-7
Shogo Kikuta, Katsuhisa Matsuo, Yushi Abe, Joe Iwanaga, Jingo Kusukawa
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Abstract

Purpose: Intraoral vertico-sagittal ramus osteotomy (IVSRO) was first reported by Choung in 1992 as a surgical procedure to decrease postoperative condylar dislocation. In 2017, Iwanaga et al. developed modified L-shaped IVSRO (mIVSRO) to reduce postoperative nerve dysfunction and achieved favorable outcomes. This study aimed to clarify the effect of mIVSRO on changes in temporomandibular joint (TMJ) symptoms and three-dimensional condylar position.

Methods: We conducted a retrospective study of thirty sides in fifteen Japanese adults diagnosed with jaw deformities who underwent mIVSRO and sagittal split ramus osteotomy (SSRO). TMJ symptoms were assessed chronologically, and the condylar long axis and the condylar position were analyzed two- and three-dimensionally using axial cephalograms and cone-beam computed tomography.

Results: Postoperative TMJ symptoms improved by 90% (9/10 sides) in the mIVSRO group and by 50% (7/14 sides) in the SSRO group. The mIVSRO group exhibited outward rotation of the condylar long axis, while the SSRO group exhibited inward rotation. Moreover, mIVSRO induced residual anteromedial-inferior deviation of the condyle. The inclination angle of the condylar process was not significantly different between the two procedures pre- and postoperatively.

Conclusion: These results clearly demonstrated the effect of mIVSRO on symptomatic TMJ. Residual changes in the position of the condyle following mIVSRO may not affect jaw function.

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改良 L 型口腔内椎体矢状突截骨术后髁状突位置改变导致的颞下颌关节症状改善:一项单中心回顾性研究。
目的:口内椎-矢状突截骨术(IVSRO)由Choung于1992年首次报道,是一种减少术后髁突脱位的手术方法。2017 年,Iwanaga 等人开发了改良 L 型 IVSRO(mIVSRO),以减少术后神经功能障碍,并取得了良好的疗效。本研究旨在明确mIVSRO对颞下颌关节(TMJ)症状和三维髁状突位置变化的影响:我们对15名被诊断为下颌畸形的日本成年人的30个侧面进行了回顾性研究,他们都接受了mIVSRO和矢状劈裂臼齿截骨术(SSRO)。颞下颌关节症状按时间顺序进行评估,髁状突长轴和髁状突位置则使用轴向头影和锥形束计算机断层扫描进行二维和三维分析:mIVSRO组术后颞下颌关节症状改善了90%(9/10侧),SSRO组术后颞下颌关节症状改善了50%(7/14侧)。mIVSRO 组的髁突长轴向外旋转,而 SSRO 组则向内旋转。此外,mIVSRO 引起了髁状突残余的前内侧-内侧偏移。两种手术前后的髁突倾斜角度无明显差异:这些结果清楚地表明了 mIVSRO 对有症状的颞下颌关节的治疗效果。mIVSRO术后髁突位置的残留变化可能不会影响下颌功能。
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来源期刊
Oral and Maxillofacial Surgery-Heidelberg
Oral and Maxillofacial Surgery-Heidelberg DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.20
自引率
5.60%
发文量
118
期刊介绍: Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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