Korean J Orthod.  2013 Apr;43(2):74-82. 10.4041/kjod.2013.43.2.74.

Condylar repositioning using centric relation bite in bimaxillary surgery

• Lee CY
• Jang CS
• Kim JW
• Kim JY
• Yang BE

• KMID: 1975145
• DOI: http://doi.org/10.4041/kjod.2013.43.2.74

Abstract

OBJECTIVE
The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device.
METHODS
The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively.
RESULTS
No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05).
CONCLUSIONS
Due to its simplicity, this method may be feasible and useful for repositioning condyles.

Keyword

Centric relation; Temporomandibular joint; Orthognathic surgery

MeSH Terms

Adult
Bites and Stings
Centric Relation
Displacement (Psychology)
Humans
Joints
Mandibular Condyle
Orthognathic Surgery
Temporomandibular Joint

Figure

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  Figure 1 A, A condylar-repositioning wire produced prior to surgery using a rapid prototype model. B, The setting of 1 point at the upper part of the estimated osteotomy line of the maxilla (①) and 2 points at the lateral margin of the ramus (②, ③) as reference points using a wire bent prior to surgery after placing a centric relation bite record in the mouth. C, D, Maxilla and mandible fixation after placement of the intermediate wafer and final wafer and performing condylar reposition using the reference points and wires.

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  Figure 2 A, The reference points were marked using a wire after placing a centric relation bite device prior to the sagittal split osteotomy. B, The position of the condyle was reconfirmed following fixation.

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  Figure 3 Schematic representation of the reference point and reference segment. See Table 1 for the abbreviations.

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