Our Summary

This research paper is a review of other studies to find out how often a condition called “condylar resorption” happens in patients who’ve had a certain kind of jaw surgery (called orthognathic surgery). This condition, condylar resorption, is when part of the jawbone starts to disappear after surgery.

The researchers looked at different databases for studies that had numbers on how often this condition happens after any kind of orthognathic surgery. They only found five good studies.

Out of over 5000 patients in these studies, about 12% developed condylar resorption. Of these patients, 70% had surgery on both jaws, 23% had surgery only on the lower jaw, and 6.5% had a specific type of surgery called a Lefort I technique.

From this, the researchers suggest that having surgery on both jaws might increase the risk of getting condylar resorption. But they warn that other things could also increase the risk, like the type of jaw problem the patient had before surgery, the kind of movement and fixation used in the surgery.

The researchers recommend that future studies should record more detailed information before and after surgery, like measurements of the head and jaw, diagnosis of jaw joint disorders, hormone levels, and CT scan images. They should do this every 6 months for the first two years after surgery. This can help to better identify what exactly increases the risk for condylar resorption.

FAQs

  1. What is the incidence of condylar resorption in patients who have undergone orthognathic surgery?
  2. Can bimaxillary surgery be considered a risk factor for condylar resorption?
  3. What other factors can contribute to the development of condylar resorption after orthognathic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about jaw surgery is to ensure they follow all post-operative instructions carefully, including any restrictions on diet, activities, and medications. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to their healthcare provider. Additionally, maintaining good oral hygiene and avoiding excessive force or pressure on the jaw can help promote proper healing and reduce the risk of complications such as condylar resorption.

Suitable For

Patients who are typically recommended for jaw surgery include those with severe dentofacial deformities, such as overbite, underbite, crossbite, and asymmetry. These deformities can affect a person’s ability to chew, speak, and breathe properly, as well as cause facial pain and discomfort. Jaw surgery may also be recommended for patients with temporomandibular joint (TMJ) disorders, sleep apnea, or obstructive breathing issues. Additionally, patients with aesthetic concerns related to the shape or size of their jaw may also benefit from jaw surgery.

Timeline

Before jaw surgery:

  • Patient undergoes initial consultation with orthodontist and oral surgeon to discuss treatment options
  • Patient undergoes comprehensive evaluation, including physical examination, dental and facial analysis, and imaging such as X-rays and CT scans
  • Treatment plan is developed, including orthodontic preparation and surgical procedure
  • Patient receives pre-operative instructions and consent forms
  • Surgery is scheduled and patient undergoes pre-operative testing and clearance

After jaw surgery:

  • Patient undergoes surgery, which may involve maxillary, mandibular, or bimaxillary procedures
  • Patient is monitored in the recovery room and then transferred to a hospital room or discharged home
  • Patient experiences swelling, pain, and discomfort in the days following surgery
  • Patient follows post-operative instructions, including dietary restrictions, pain management, and oral hygiene care
  • Patient attends follow-up appointments with the oral surgeon and orthodontist for monitoring and adjustments
  • Patient undergoes orthodontic treatment to finalize the occlusion and alignment of the teeth
  • Patient experiences gradual improvement in function and aesthetics as the jaw heals and settles into its new position
  • Long-term follow-up may be necessary to monitor for any complications or changes in jaw function or appearance.

What to Ask Your Doctor

  1. What is the specific reason for recommending jaw surgery in my case?
  2. What are the potential risks and complications associated with jaw surgery, including condylar resorption?
  3. How common is condylar resorption in patients undergoing orthognathic surgery?
  4. Are there any factors that may increase my risk for developing condylar resorption?
  5. What are the alternative treatment options available for my condition?
  6. What is the expected recovery process after jaw surgery, and how long will it take?
  7. How will my bite and facial appearance be affected by the surgery?
  8. Will I need to follow any specific post-operative care instructions to prevent complications?
  9. How often will I need follow-up appointments after the surgery?
  10. Are there any specific lifestyle changes or restrictions I should be aware of after jaw surgery?

Reference

Authors: NiÑo-Sandoval TC, Almeida RAC, Vasconcelos BCDE. Journal: Braz Oral Res. 2021 Feb 12;35:e27. doi: 10.1590/1807-3107bor-2021.vol35.0027. eCollection 2021. PMID: 33605357