A Comparative Radiological Evaluation of the Condylar Position in Pre and Post Bilateral Sagittal Split Osteotomy

Purpose: Several procedures have been described for correction of Orthognathic deformities of the mandible. Currently, the Bilateral Sagittal Split Osteotomy (BSSO) maintains its popularity because of its versatility and its amenability to rigid fixation techniques. Postoperative change in the position of the condyle can be classified, using radiographs, as either physiological condylar remodelling (CR) or pathological condylar resorption (PCR) according to the severity of the observed change in condylar morphology, which demonstrates a significant relation between condylar volume loss and skeletal relapse after Bilateral sagittal split osteotomy. The present study was conducted to evaluate the changes in the condylar position following Bilateral Sagittal Split Osteotomy using lateral cephalograms and to quantify the amount of displacement of the condyle.

Methods: Ten patients who needed Bilateral Sagittal Split Osteotomy for mandibular advancement and setback with a mean age group of 20 from January 2017 to September 2018 were included in the study. The standardized Bilateral Sagittal Split Osteotmy procedure was carried out under general anaesthesia. Lateral cephalograms were taken preoperative, immediate post-operative, after 1 month and 3 months to evaluate the condylar position. Movement of condyles is assessed in which horizontal ( i.e anterior and posterior) and vertical (i.e superior and inferior) change in the postion was evaluated using lateral cephalogram superimposition method.

Results: There is no statistically significant movement of condyles however there was movement of the condyles in horizontal and vertical dimensions at the immediate post operative period, one month and third month postoperative period.

Conclusion: Eventhough there is no statistically significant movement of condyles, there is change in movement of condyles in the insignificant ratio. However, larger sample size and larger follow up period is required to achieve a conclusive results.