Post-surgical Relapse Of Patients With Idiopathic Condylar Resorption Who Underwent Functional Splint Therapy Following Mandibular Advancement: A Retrospective Study

Objectives1.To find out the influence of functional splint therapy,a conservative treatment which stabilizes the relationship between the condylar head and glenoid fossa,on post-surgical relapse in patients with idiopathic condylar resorption.2.To provide evidence for further clinical research.Method13 patients,presenting to the Department of Craniofacial-Orthodontic,Shanghai People’s Ninth hospital between 2008-2012,who underwent orthognathic surgery for mandibular advancement were included in this retrospective study.Patients were treated with the conventional functional splint therapy for 7.5±1.5 months followed by orthognathic surgery.Cephalometric analysis and temporomandibular joint spaces on serial Magnetic Resonance Images were measured prior to orthognathic surgery(T0),immediate post-surgery(T1),and at least 12 months follow-up(T2)for evaluation of the long-term stability.Compare the differences of data between two periods using statistical analysis.ResultAll of the patients obtained an aesthetic facial profile after the orthognathic surgery and a normal occlusion after treatment.Normal protrusive and lateral excursion were presented.The mean advancement of the mandible immediately following surgery(S Vert.-B,T1-T0)was 5.05±3.54 mm.At the long-term followup after surgery,the mean backward movement of(T2-T1)was-1.64±2.48 mm.The mean change of SNB(T2-T1)was-0.27±2.96°(p=0.239),the mean change of ANB(T2-T1)was 0.32±1.51°(p=0.724),the mean change of ramus height(Co-Go)during follow-up was 0.17±1.93mm(p=0.479).No statistical significance in difference of temporomandibular joint space between T1 and T2(0.17±1.93).The average follow-up length was 23±14.48 months.1 out of 13 patients presented mild post-surgical relapse backward movement of mandible of 2-4mm,1 out of 13 patients showed >4mm of backward movement.ConclusionPatients who underwent functional splint therapy showed stable condylar position in condylar fossa.Functional splint therapy reduces the post-surgical relapse in patients with idiopathic condylar resorption.Functional splint therapy may be of value in patients with ICR treated with orthognathic surgery combined orthodontic.