Condylar Remodeling After Orthognathic Surgery: A Retrospective Tomographic Evaluation of Angular, Volumetric, and Morphologic Changes in Skeletal Class II and III Patients.

BACKGROUND

Orthognathic surgery changes alter the biomechanics of the stomatognathic system, especially impacting the mandibular condyle. This study aims to evaluate 3-dimensional condylar changes after bimaxillary surgery in skeletal class II and III patients, and to analyze the relationships among these changes.

MATERIALS AND

METHODS

This study included 40 patients with skeletal class II and III deformities. Cone beam computed tomography (CBCT) data of patients were imported into Mimics Medical 21.0 (Materialise, Belgium) software to obtain movements of mandible and maxilla, angular and volumetric condylar angles. Three-dimensional surface superimposition and remodelling analyses were performed using Geomagic Control X (3D Systems, USA) software with color maps.

RESULTS

After 1 year, class II patients showed significant bilateral condylar volume loss, while class III patients showed a significant reduction only on the left side. No significant angular changes were observed in any plane. Transverse condylar length decreased in both groups, more prominently in class II. Remodeling analysis revealed anterior apposition and posterior resorption in class II, whereas class III showed anterior and medial apposition. Lateral resorption was common in both groups. In class III patients, medial rotation of the left condyle was negatively correlated with its volume.

CONCLUSION

Orthognathic surgery causes no significant angular changes, and volumetric reductions remain within adaptive physiological limits. As part of condylar remodeling, apposition occurs anteriorly in class II and medially in class III patients, reflecting an adaptive response to lateral resorption.