Indications to the use of condylar repositioning devices in the surgical treatment of dental-skeletal class III

Purpose: The aim of this report was to compare the clinical and radiographic findings observed at the 12-month follow-up in 2 groups of 15 patients who underwent Le Fort I and bilateral sagittal split osteotomy for the correction of dental-skeletal Class III. In the first group, the condylar positioning devices were used, whereas in the second group, an alternative method was used for the intraoperative assessment of mandibular repositioning. Materials and Methods: All of the patients of our study in the immediate presurgical period were without temporomandibular joint disorders and with a normal anatomic relationship between condyle and fossae. The condyle position and morphology were examined at the 12-month follow-up through cephalometric measurements and the postsurgical findings in both groups were compared with those observed in the presurgical period. Results: In all of the 30 patients in our study, no relapse or postsurgical temporomandibular joint disturbance was observed at the 12-month follow-up. Variations in condyle position of more than 2 mm or 2degrees were not observed in the 15 patients treated with condylar positioning devices. Changes in condyle position between 2 and 4 mm and 2degrees and 4degrees were observed in 6 of the 15 patients treated without the devices. Conclusions: The use of condylar positioning devices can be avoided in patients with dental-skeletal Class III without presurgical temporomandibular dysfunction. The manual positioning of the mandibular condyle is easier, but it requires the utmost care and an experienced operator. (C) 2003 American Association of Oral and Maxillofacial Surgeons.