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Three-dimensional evaluation of condylar position after mandibular reconstruction with a fibula free flap—comparison of different surgical techniques

  • Author Footnotes
    1 This work was performed by K. L. Schulz in partial fulfilment of the requirements for obtaining the degree Dr. med. dent.
    K.L. Schulz
    Footnotes
    1 This work was performed by K. L. Schulz in partial fulfilment of the requirements for obtaining the degree Dr. med. dent.
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
    Search for articles by this author
  • M.R. Kesting
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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  • C.-P. Nobis
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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  • R. Matta
    Affiliations
    Department of Prosthodontics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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  • R. Lutz
    Correspondence
    Correspondence to: Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Glückstraße 11, 91054 Erlangen, Germany. Fax: +49 9131 8534219.
    Affiliations
    Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
    Search for articles by this author
  • Author Footnotes
    1 This work was performed by K. L. Schulz in partial fulfilment of the requirements for obtaining the degree Dr. med. dent.
Published:October 21, 2022DOI:https://doi.org/10.1016/j.ijom.2022.10.003

      Abstract

      Three-dimensional positional changes of the temporomandibular joint after mandible reconstruction using microvascular fibula flaps were investigated in 58 patients. The results of preoperative virtually planned surgery, intraoperative resection- and cutting-guided surgery, and non-guided surgery were compared. Pre- and postoperative computed tomography data of each patient were processed and superimposed digitally. The condyle deviations and rotations along the axes and planes of the skull, as well as Euclidean distances, were determined. Reliability analyses, descriptive statistics, and non-parametric tests were performed with the alpha level set at P = 0.05. Reliability proved to be excellent for all variables. The median Euclidean distance was 2.07 mm for the left condyle and 2.11 mm for the right condyle. Deviations of ≥ 10 mm occurred in nine (16%) cases. The maximum deviation occurred in the horizontal plane and the least deviation in the sagittal plane. Median rotation was ≤ 1.4° around all axes. The condylar displacements did not differ significantly between the different surgical techniques investigated. The three-dimensional measurement method applied is highly reliable for evaluating the three-dimensional condylar position after mandibular reconstruction.

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