Condylar head remodeling compensating for condylar head displacement by orthognathic surgery

The purpose of this study was to evaluate the association between kind of condylar displacement due to orthognathic surgery and the subsequent adaptive condylar head remodeling. The sample in this retrospective cohort study consisted of 30 patients (12 female and 18 male; mean age 22.7 y) with skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (SSRO). Three-dimensional superimpositions of cone-beam computed tomography (CBCT) scan derived images from immediately after and 6 months after surgery were to reveal the type of remodeling, while images from before and immediately after surgery were to identify the type of condylar displacement. Laterally displaced condyles showed bone resorption on the lateral surfaces and deposition on the medial surfaces, whereas the contrary was found in medially displaced condyles. Anteriorly displaced condyles showed resorption on the anterior surfaces and deposition on the posterior surfaces, whereas the contrary was found in posteriorly displaced condyles. Superior surfaces of the condyles showed bone resorption regardless of displacement direction. The results indicate that condylar remodeling patterns (resorption/deposition) are determined by the direction of condylar displacement during surgery. However, condylar displacement by surgery is not completely compensated by condylar head remodeling, especially in case of downward displacement.