The Effect of a Condylar Repositioning Plate on Condylar Position and Relapse in Two-Jaw Surgery

• Published in: Archives of plastic surgery Vol. 44; no. 1; pp. 19 - 25
• Main Authors: Jung, Gyu Sik, Kim, Taek Kyun, Lee, Jeong Woo, Yang, Jung Dug, Chung, Ho Yun, Cho, Byung Chae, Choi, Kang Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Plastic and Reconstructive Surgeons 01-01-2017; Thieme Medical Publishers, Inc; 대한성형외과학회
• Subjects: le fort osteotomy; Original; orthognathic surgery; sagittal split ramus osteotomy; 성형외과학; Orthognathic surgery; Sagittal split ramus osteotomy; Le Fort osteotomy
• ISSN: 2234-6163; 2234-6171
• DOI: 10.5999/aps.2017.44.1.19

Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship.
We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate.
A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits.
Our condylar repositioning method using a centric relation splint and mini-plate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.