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OBJECTIVES: To assess surgery and short-term post-surgery changes in the position of the condyles, rami and chin after mandibular advancement.  METHODOLOGY: Pre-surgery (T1), 1 week post-surgery (T2), and 6 week post-surgery (T3) CBCT scans were acquired for 20 retrognathic patients with short or normal face height. 3D models were built and superimposed through a fully automated voxel-wise method using the cranial base of the pre-surgery scan as reference. Anatomic regions of interest were selected and analyzed separately. Within-subject surface distances between T1-T2, T2-T3, and T1-T3 were computed. Color-coded maps and semi-transparent display of overlaid structures allowed the evaluation of displacement directions.  RESULTS: After an antero-inferior chin displacement with surgery in all cases (&gt;4 mm in 87.5%), 25% of the patients showed some kind of posterior movement (&lt; 3 mm), and 69% showed an antero-superior movement after splint removal. Comparing T1-T3, an antero-inferior (87.5% of the cases) or only inferior (12.5%) displacement was observed (&gt;4 mm in 80%). Considering all directions of displacement, the surface distance differences for the condyles and rami were small: 77.5% of the condyles moved &lt;2 mm with surgery (T1-T2), and 90% moved &lt;2 mm in the short-term (T2-T3) and in the total evaluation (T1-T3), while the rami showed a &lt;3 mm change with surgery in 72.5% of the cases, and a &lt;2 mm change in 87.5% (T2-T3) and in 82% (T1-T3).  CONCLUSIONS: Expected displacements with surgery were observed and post-surgery changes suggested a short-term adaptive response toward recovery of condyle and ramus displacements. The changes on the chin following splint removal suggested an acceptable adaptation, but with considerable individual variability.

Avaliação da cirurgia de avanço mandibular por meio da superposição de modelos tomográficos tridimensionais