Long-term condylar bony changes following combined orthodontic-orthognathic surgery treatment in skeletal class III patients

To investigate long-term (4 years) effects of combined orthodontic-orthognathic surgery treatment on condylar bone structure and volume in skeletal Class III patients. The study included 27 (23 females, 4 males) patients diagnosed with skeletal Class III malocclusion, who underwent bimaxillary orthognathic surgery. The mean age of the patients at surgery was 23.5 ± 6.4 years. Cone-beam computed tomography (CBCT) images, obtained before surgery (mean 1.3 ± 1.9 months) and at long-term follow-up (mean 4.6 ± 0.6 years), were analysed. Condylar bony changes were assessed and condyles were classified as normal, having condylar remodeling or having degenerative joint disease. Three-dimensional models of the condyles were used to evaluate the changes of condylar volume pre- and post-surgery. The percentage of radiographically-detected subcortical sclerosis had statistically significantly (p < 0.001) increased after surgery. A higher proportion (p = 0.012) of the condyles with the status of remodeling was found at the long-term inspection. Condylar volume decreased on average (sd) by 4.5 (135.4) mm³, representing about 0.3 % of the total volume. Combined orthodontic-orthognathic surgery treatment induced condylar bone remodeling 4 years after surgery. The quantitative assessment showed minor changes of the condylar volume at the long-term follow-up in skeletal Class III patients.