A case report of condylar remodeling after orthognathic surgery with a combination of intraoral vertical ramus osteotomy and sagittal split ramus osteotomy

DOI 6 References
  • IZAWA Takashi
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • HORIUCHI Shinya
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • TSUJI Keiko
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • FUJIHARA Shinji
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • OBA Yasuo
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • TANAKA Eiji
    Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima
  • MORIYAMA Keiji
    Department of Maxillofacial Orthognathics, Graduate School, Tokyo Medical and Dental University

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Other Title
  • 下顎枝垂直骨切り術と下顎枝矢状分割術を併用した外科的矯正治療後に下顎頭のリモデリングを認めた一症例

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This report describes a skeletal mandibular protrusion with facial asymmetry treated by orthognathic surgery combined with IVRO and SSRO, which revealed bone remodeling on the shifted-side condyle after the surgery. The patient, a 15-year 6-month-old female, complained of anterior crossbite. At the initial stage, overjet and overbite were -2.5mm and +4.5mm, respectively. The molar relationship was Angle Class III, and she was diagnosed as Skeletal Class III with mandibular protrusion (ANB=-1.5°). After preoperative orthodontic treatment, she underwent orthognathic surgery including SSRO on the right side and IVRO on the left side. The amounts of mandibular setback were 9mm and 5mm on the right and left side of the mandible, respectively. From the tomography taken before surgery, and 3 and 12 months after surgery, the left condyle moved anteroinferiorly immediately after surgery. After 12 months, the posterior surface of the left condyle revealed bone remodeling and the subsequent change of the condylar morphology. From this case report, orthognathic surgery combined with IVRO and SSRO was shown to be an effective treatment for an asymmetrical mandibular protrusion. It was also shown that careful observation for a long time is crucial for long-term stability.

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