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Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award of Special Merit

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Page 1: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

Three Dimensional Quantification of

Post-Surgical Condylar Displacement

PAULA ZABALEGUIDan Grauer DDS, MS, PhD & Michael Gunson DDS, MD

Thomas M. Graber Award of Special Merit

Page 2: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

P U R P O S E O F O U R S T U D Y

To measure, in three dimensions,

translation and rotation movements

of the condyle after orthognathic

surgery

Page 3: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

M AT E R I A L S

17 Consecutive Patients [10M, 7F]

Skeletal Class II Or Class III Malocclusion

Pre-surgical Orthodontic Treatment + Bi-maxillary Surgery (Same Oral

Surgeon)

Maxillary Le Fort I Osteotomy & BSSO

Rigid Fixation (Plates)

Full head CBCT scans, pre surgery and 2 weeks after surgery

Page 4: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

M E T H O D

1) Segment the Region of Interest: condyles and fossae, pre and

post surgical

2) Export as separate surfaces

3) Superimpose on Glenoid Fossa

4) Measure condylar displacement:

Translation (mm): x,y,z

Rotation (degrees): x,y,z

Page 5: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

1. Segment the Region of Interest

Page 6: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

2. Export as Separate Surfaces

Page 7: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

3. Superimpose on Glenoid Fossae

Page 8: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

4. Measure Condylar Displacement from PreSurgical (Blue) to Post Surgical (Red)

Page 9: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

0,00

1,00

2,00

3,00

4,00

x y z

0

4

10.15

-3.80

0.78

AVERAGE CONDYLAR TRANSLATION (MM)

-3.80

0.78

0.15

R E S U LT S

Page 10: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

-0.30

0.63

-0.27

AVERAGE CONDYLAR ROTATION (º)

0,00

1,00

x y z

000

0,063

0,3070,277

R E S U LT S

Page 11: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

D I S C U S S I O N

T R A N S L A T I O N Y ( A N T E R O P O S T E R I O R )

What i s th i s k ind o f

movement due to?

Page 12: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

What i s th i s k ind o f

movement due to?

D I S C U S S I O N

A N T E R O P O S T E R I O R R O T A T I O N

Page 13: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

What i s th i s k ind o f

movement due to?

D I S C U S S I O N

M E D I O L A T E R A L R O T A T I O N

Page 14: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

Why d i d n ’ t w e f i n d t h e s e k i n d s o f

m o v e m e n t s ?

D I S C U S S I O N

M E D I A L A N D S U P E R I O R M O V E M E N T

Page 15: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

C A S E P R E S E N TAT I O N

B l u e = b e f o r e s u r g e r y R e d = a f t e r s u r g e r y

Page 16: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

C O N C LU S I O N S

1. A method to measure Condylar Displacement in 3 planes of space

was established, both for rotation and translation

2. Posterior displacement

3. Anteroposterior Rotation

4. MedioLateral Rotation

5. Surgical stability

Page 17: DDS, MS, PhD DDS, MD · Three Dimensional Quantification of Post-Surgical Condylar Displacement PAULA ZABALEGUI Dan Grauer DDS, MS, PhD & Michael Gunson DDS, MD Thomas M. Graber Award

Advanced Orthodontic Program :

University of Southern Cali fornia

Dr. Dan Grauer

Dr. Michael Gunson

A C K N O W L E D G E M E N T S