Radiological Changes in the Temporomandibular Joints of Patients With Angle Class II Malocclusion Following Mandibular Advancement Surgery and Their Correlation With Condylar Displacement and Clinical TMJ Findings
Heleia Nestal Zibo, Margus Pihlak, Peeter Raudvere, Ülle Voog-OrasPurpose:
To evaluate postoperative radiological changes in the temporomandibular joints after bilateral sagittal split ramus osteotomy (BSSO) for mandibular advancement and assess their relationship with condylar positional changes and clinical findings.
Methods:
Twenty-three patients with Angle Class II malocclusion underwent mandibular advancement surgery with rigid fixation. Computed tomography (CT) and magnetic resonance imaging (MRI) scans were obtained preoperatively (T1), at 2 weeks (T2), and at 6 months (T3) after surgery. Radiological changes, condylar positional changes, and clinical symptoms were analyzed using correlation and regression analyses.
Results:
Computed tomography showed increased condylar erosion postoperatively and increased sclerosis at T3, while pseudocysts, flattening, and osteophytes showed no significant changes. Magnetic resonance imaging demonstrated no major changes in disc position, whereas joint effusion increased temporarily at T2. Disc displacement was moderately associated with pain only at T2. No significant associations were found between condylar positional changes and most TMJ variables. Condylar flattening showed the strongest association with postoperative condylar translation.
Conclusion:
Bilateral sagittal split ramus osteotomy for mandibular advancement causes mild postoperative TMJ radiological changes, mainly involving condylar bone structure and joint effusion. These findings show limited association with condylar positional changes and clinical symptoms, with condylar flattening being the most consistently related imaging feature.