Electromagnetic navigated condylar positioning after high oblique sagittal split osteotomy of the mandible: a guided method to attain pristine temporomandibular joint conditions?

Publication date: Available online 29 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Moritz Berger, Igor Nova, Sebastian Kallus, Oliver Ristow, Urs Eisenmann, Hartmut Dickhaus, Michael Engel, Christian Freudlsperger, Jürgen Hoffmann, Robin Seeberger
ObjectivesReproduction of the exact preoperative proximal-mandible position after osteotomy in orthognathic surgery is difficult to achieve. This clinical pilot study evaluates an electromagnetic navigation (EM) system for condylar positioning after high oblique sagittal split osteotomy.Study DesignFollowing high oblique sagittal split osteotomy as part of two-jaw surgery, the position of ten condyles was intraoperatively guided by an EM navigation system. As a control, 10 proximal segments were positioned by standard manual replacement. Accuracy was measured by pre- and postoperative cone beam computer tomography imaging.ResultsOverall, EM condyle repositioning was equally accurate compared with manual repositioning (p>0.05). Subdivided into the three axis, significant differences could be identified (p<0.05). Nevertheless, no significantly and clinically relevant dislocations of the proximal segment of either the EM or the manual repositioning method could be shown (p>0.05).ConclusionThis pilot study introduces a guided method for proximal segment positioning, after high oblique sagittal split osteotomy, by applying the intraoperative EM system. The data demonstrate the high accuracy of EM navigation, although manual replacement of the condyles could not be surpassed. However, EM navigation can avoid clinically hidden, severe malpositioning of the condyles.



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