A recent study has shed light on the incidence and risk factors associated with condylar resorption following orthognathic surgery, highlighting it as a significant complication affecting patients undergoing these procedures. Conducted by researchers at the Department of Oral & Maxillofacial Surgery at the University Hospital Leuven, Belgium, the study analyzed data from 200 patients who underwent bilateral sagittal split osteotomy (BSSO) between May 2017 and December 2019.
Condylar resorption, which is characterized by sudden loss of condylar volume, can severely impact the outcome of orthognathic surgery, leading to functional problems and aesthetic concerns. The research revealed a troubling 9.5% incidence rate of condylar resorption among the patients studied, with those affected experiencing, on average, a 17% volume loss, along with considerable ramal height loss (3.9 mm) and posterior displacement (3.1 mm) of the mandible.
Researchers uncovered several risk factors linked to the development of condylar resorption. Key findings included younger age, undergoing bimaxillary surgery with genioplasty, greater mandibular advancement, upward movements of the distal segment, and smaller preoperative condylar volumes. Notably, machine learning techniques identified the amount of mandibular advancement as the most important predictor for the occurrence of condylar resorption.
Univariable analyses also pointed to compressive movements of the ramus and higher mandibular plane angles as contributing factors. These revelations provide valuable insights for clinicians, underscoring the need for careful surgical planning and postoperative monitoring of patients.
The study emphasizes the importance of identifying risk factors, as they enable modifications to surgical plans aimed at reducing the likelihood of resorption. The authors note, "Identifying risk factors allows surgical plans to be adjusted to reduce the likelihood of resorption, and patients can be more selectively screened postoperatively."
The findings suggest condylar resorption may be more common than previously thought, contrasting anecdotal clinical experiences. Traditionally, the focus has been on the most evident cases of resorption, often leading to underdiagnosis of subtler cases during routine follow-ups. The authors recommend incorporating advanced imaging techniques and analytical tools as standard practice to improve detection rates.
Overall, this study acts as a clarion call for oral and maxillofacial surgeons to adopt enhanced measures for monitoring patients at risk of condylar resorption following orthognathic surgery. By doing so, they may prevent prolonged orthodontic treatments and optimize surgical outcomes for patients, ensuring the benefits of surgery are fully realized.