Evaluation of condylar translation by sonography versus axiography in orthognathic surgery patients¹

Abstract 

Purpose:

This study compares measurement of the condylar translation by sonography or axiography in preoperative assessment and follow-up of orthognathic surgery patients.

Patients and Methods:

Forty-seven moderately dysgnathic patients had consecutive examinations by axiography and sonography in a blind fashion at a single time point by 2 observers. Thirty-nine different dysgnathic patients, scheduled for isolated Le Fort I osteotomy, had preoperative condylar translation and 24-month follow-up measured randomized by either axiography (25 patients as control group) or sonography (14 patients as study group).

Results:

The examination time for axiography was 20 minutes average versus 2 minutes for sonography. The mean differences were 1.7 mm in opening, 2.1 mm in protrusion, and 3.3 mm for mediotrusion. Pearson’s proportionality quotient was r = 0.75, analysis of variance (P < .95, F = 3.9, α = .05 significance level) was not significant. The 24-month longitudinal follow-up showed a Pearson’s proportionality quotient of r = 0.7 between study and control group, and no significant difference in analysis of variance (P < .075, F = 2.81, α = .05 significance level).

Conclusion:

Sonography proved adequate for assessment and follow-up of condylar translation compared with axiography in orthognathic surgery patients. Temporomandibular joint sonography was faster and more comfortable, allowed 1-week postoperative examination and reexaminations, and was equally exact. Anatomic details like joint degeneration and disc displacement could be assessed. However, sonography did not measure the inclination of the condylar track.

• 1 Received from Maxillofacial and Plastic Facial Surgery, J. W. Goethe University Medical Center, Frankfurt, Germany.