Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 10 , Pages 1963-1968, October 2007

Computer-Assisted Condyle Positioning in Orthognathic Surgery

  • Rüdiger Marmulla, PhD, MD, DMD

      Affiliations

    • Assistant Professor, Department of Cranio-Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Marmulla: Department of Cranio-Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
    • ,
  • Joachim Mühling, PhD, MD, DMD

      Affiliations

    • Head, Department of Cranio-Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.

Purpose

Le Fort I repositioning osteotomy can affect the position of the temporomandibular joints (TMJs). During the operation, the surgeon does not have direct visual control of the TMJ. In this study, the TMJ movements in patients undergoing a Le Fort I repositioning osteotomy were recorded intraoperatively using the Surgical Segment Navigator (SSN) computer-assisted navigation system.

Patients and Methods

Unintended TMJ positions resulting from conventional repositioning of the maxillary segment were recorded. The TMJ positions in these patients were then corrected in relation to the skull base, using information obtained from the SSN. The position of the condyle was then redetermined. The accuracy of conventional and SSN-guided segment adjustments were compared in terms of their influence on TMJ position in the same group of patients.

Results

The median spacial malposition of the condyles without navigation was 2.4 mm. Corrective “SSN positioning” on the same patients reduced this to 0.7 mm.

Conclusions

SSN allows accurate intraoperative navigation of the TMJ.

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PII: S0278-2391(06)02189-6

doi:10.1016/j.joms.2006.11.024

Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 10 , Pages 1963-1968, October 2007

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