Effects of Sagittal Split Ramus Osteotomy on Condylar Position and Temporomandibular Joint Symptoms

Comparing Three Surgical Methods

Abstract

This study investigates the effects of sagittal split ramus osteotomy (SSRO) on condylar position and temporomandibular joint (TMJ) symptoms.
The subjects were 51 patients (13 males and 38 females) in whom mandibular protrusions were corrected by SSRO; they were divided into three subtypes on the basis of the lateral bone cut location. The joints were examined clinically for pain, sound and maximum interincisal opening before surgery and at least six months after surgery. Submentovertex radiographs were taken before and immediately after surgery. The changes in condylar position were assessed by measuring the condylar angle, intercondylar axes angle and distance between the centers of the condyles.
After SSRO, the condyles rotated inward (p < 0.01) on the axial plane, but the distances between their centers did not change significantly. TMJ signs and symptoms disappeared in four (31%) of the 12 symptomatic patients, worsened in one (8%) of the symptomatic patients and developed in three (8%) of the 39 asymptomatic patients six months after surgery. There were no significant differences in any of the parameters among the three subtypes of SSRO.