Condylar head remodeling following mandibular setback osteotomy for prognathism: A comparative study of different imaging modalities

Purpose. Condylar remodeling, which develops after mandibular setback osteotomy, was evaluated and compared in CT plain film radiographs, and MR images acquired postoperatively. Methods. Thirty-nine patients treated with sagittal split ramus osteotomy (SSRO) and 46 patients treated with intraoral vertical ramus osteotomy (IVRO) were studied. Remodeling as seen in the images and the diagnostic agreement between imaging modalities was evaluated. Results. A newly formed bone layer in the posterior part of the condylar head was identified as a sign suggestive of remodeling. This sign was seen predominantly at periods over 6 months postoperatively. IVRO Subjects had a higher incidence of remodeling than did the SSRO group. The diagnostic agreement between the 3 imaging modalities was substantial. There was a positive correlation between postoperative condylar displacement and the incidence of remodeling. Conclusions. The incidence of postoperative condylar head remodeling may be predictable. High-close postoperative imaging studies to assess the TMJ should be restricted to those cases having a clear need for such studies.