Direction and Range of Condylar Positional Changes in the First-Year Post-surgical Orthodontics Interventions in Adult Patients with Skeletal Class III Deformity: A Systematic Review and Meta-analysis

J Maxillofac Oral Surg. 2024 Oct;23(5):1138-1162. doi: 10.1007/s12663-023-02042-y. Epub 2023 Nov 19.

Abstract

Objectives: Assess the available scientific literature regarding the direction and extent of condylar positional changes during the first year of post-surgical orthodontics interventions in class III patients.

Materials and methods: PubMed, Cochrane Library, Embase, and Google Scholar databases were searched up to March 2022 for studies involving the measurement of condylar positional changes after surgical treatment of Class III dentofacial deformity in adults with BSSO without or without Le Fort I osteotomies. The methodological index for non-randomized studies (MINORS) was utilized to assess the risk of bias and quality of non-randomized studies. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was condyle positional changes between the following time points: T0: before treatment, T1: immediately post treatment, T2: 4, 6, or 9 months post treatment, T3: one year post treatment.

Results: Nineteen studies were included in the systematic review. Eleven studies were deemed low quality, and the rest were of medium quality. The meta-analysis included 12 studies and showed statistically significant downward, outward positional changes at T1(Immediately after surgery). Inward Yaw rotation was significant at T1(1-4 month post-surgery) and T2(4-9 months post-surgery).

Conclusion: Surgically induced condylar changes tend to go back to normal within the first year after surgery, except for condylar yaw rotations.

Keywords: Class III malocclusion; Condyle; Orthodontics; Orthognathic surgery.

Publication types

  • Review