{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:29:33Z","timestamp":1771036173170,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intraoral vertical ramus osteotomy (IVRO) is used to treat mandibular prognathism and temporomandibular disorders. However, the improvement of temporomandibular disorders after IVRO is considered to be due to the anterior and downward movement of the mandibular condyle, which may lead to condylar sag, and in the worst case, condylar luxation. In this retrospective cohort study, we examined factors potentially associated with condylar sag. Univariate analysis indicated that condylar sag was significantly associated with the following factors: magnitude of setback (<jats:italic>P<\/jats:italic>\u2009=\u20090.001), less than 3\u00a0mm setback (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), presence of temporomandibular joint (TMJ) symptoms (<jats:italic>P<\/jats:italic>\u2009=\u20090.002), Wilkes classification (<jats:italic>P<\/jats:italic>\u2009=\u20090.039), occlusal cant correction\u2009\u2265\u20092\u00a0mm (<jats:italic>P<\/jats:italic>\u2009=\u20090.018), and mandibular condyle deformation (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Setback magnitude (<jats:italic>P<\/jats:italic>\u2009=\u20090.032) and TMJ symptoms (<jats:italic>P<\/jats:italic>\u2009=\u20090.007) remained significant in the multivariate analysis. In the receiver operating characteristic curve, the setback magnitude cut-off value for condylar sag after IVRO was 3.25\u00a0mm. Thus, the incidence of condylar sag after IVRO is increased with a smaller setback magnitude (\u2264\u20093.25\u00a0mm) and the presence of TMJ symptoms. These factors should be evaluated by surgeons during treatment planning for IVRO to estimate condylar sag, and it may be possible to predict the risk of condylar luxation.<\/jats:p>","DOI":"10.1038\/s41598-021-89968-w","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T10:04:53Z","timestamp":1621245893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Predisposing conditions for condylar sag after intraoral vertical ramus osteotomy"],"prefix":"10.1038","volume":"11","author":[{"given":"Satoshi","family":"Rokutanda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-Ichi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Souichi","family":"Yanamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Omori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Rokutanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Yoshimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumi","family":"Fujishita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Morita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Umeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"89968_CR1","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1097\/00006534-197711000-00010","volume":"60","author":"TR Broadbent","year":"1977","unstructured":"Broadbent, T. R. & Woolf, R. M. Vertical ramisection for prognathism. Plast. Reconstr. Surg. 60, 735\u2013743 (1977).","journal-title":"Plast. Reconstr. Surg."},{"key":"89968_CR2","first-page":"333","volume":"33","author":"HD Hall","year":"1975","unstructured":"Hall, H. D., Chase, D. C. & Payor, L. G. Evaluation and refinement of the intraoral vertical subcondylar osteotomy. J. Oral Surg. 33, 333\u2013341 (1975).","journal-title":"J. Oral Surg."},{"key":"89968_CR3","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1016\/0278-2391(87)90308-9","volume":"45","author":"HD Hall","year":"1987","unstructured":"Hall, H. D. & Mckenna, S. J. Further refinement and evaluation of intraoral vertical ramus osteotomy. J. Oral Maxillofac. Surg. 45, 684\u2013688 (1987).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"89968_CR4","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.oooo.2019.08.012","volume":"128","author":"S Rokutanda","year":"2019","unstructured":"Rokutanda, S. et al. Effects of the changes in the condylar long axis angle and condylar position on temporomandibular symptoms after intraoral vertical ramus osteotomy: a preliminary study. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 128, 597\u2013605 (2019).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"89968_CR5","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/S0278-2391(00)90063-6","volume":"58","author":"GE Ghali","year":"2000","unstructured":"Ghali, G. E. & Sikes, J. W. Jr. Intraoral vertical ramus osteotomy as the preferred treatment for mandibular prognathism. J. Oral Maxillofac. Surg. 58, 313\u2013315 (2000).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"89968_CR6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/S0901-5027(89)80011-6","volume":"18","author":"A Peterssen","year":"1989","unstructured":"Peterssen, A. & Willmar-Hogeman, K. Radiographic changes of the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. Int. J. Oral Maxillofac. Surg. 18, 27\u201331 (1989).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"89968_CR7","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/S0300-9785(86)80079-5","volume":"15","author":"O Eckerdal","year":"1986","unstructured":"Eckerdal, O., Sund, G. & Astrand, P. Skeletal remodeling in the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. Int. J. Oral Maxillofac. Surg. 15, 233\u2013239 (1986).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"89968_CR8","unstructured":"Bell, W. H. Mandibular prognathism. In Modern Practice in Orthognathic and Reconstructive Surgery 61, 2111\u20132137 (Saunders, 1992)."},{"key":"89968_CR9","doi-asserted-by":"publisher","first-page":"3828","DOI":"10.1038\/s41598-020-60838-1","volume":"10","author":"S Rokutanda","year":"2020","unstructured":"Rokutanda, S. et al. Anterior relapse or posterior drift after intraoral vertical ramus osteotomy. Sci. Rep. 10, 3828. https:\/\/doi.org\/10.1038\/s41598-020-60838-1 (2020).","journal-title":"Sci. Rep."},{"key":"89968_CR10","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.tripleo.2007.03.007","volume":"104","author":"K Yamauchi","year":"2007","unstructured":"Yamauchi, K., Takenobu, T. & Takahashi, T. Condylar luxation following bilateral intraoral vertical ramus osteotomy. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 104, 747\u2013751 (2007).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"89968_CR11","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.ijom.2015.07.008","volume":"45","author":"Y Kawase-Koga","year":"2016","unstructured":"Kawase-Koga, Y. et al. Complications after intraoral vertical ramus osteotomy: relationship to the shape of the osteotomy line. Int. J. Oral Maxillofac. Surg. 45, 200\u2013204 (2016).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"89968_CR12","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/0278-2391(91)90372-S","volume":"49","author":"KS Rotskoff","year":"1991","unstructured":"Rotskoff, K. S., Herbosa, E. G. & Nickels, B. Correction of condylar displacement following intraoral vertical ramus osteotomy. J. Oral Maxillofac. Surg. 49, 366\u2013372 (1991).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"89968_CR13","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1097\/SCS.0b013e3181d7ae70","volume":"21","author":"F Ritto","year":"2010","unstructured":"Ritto, F., Parente, E., da Silveira, H. M., Medeiros, P. J. & de Moraes, M. Avoiding condylar displacement after intraoral vertical ramus osteotomy. J. Craniofac. Surg. 21, 826\u2013829 (2010).","journal-title":"J. Craniofac. Surg."},{"key":"89968_CR14","first-page":"287","volume":"57","author":"CH Wilkes","year":"1978","unstructured":"Wilkes, C. H. Structural and functional alterations of the temporomandibular joint. Northwest Dent. 57, 287 (1978).","journal-title":"Northwest Dent."},{"key":"89968_CR15","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1259\/0007-1285-38-450-401","volume":"38","author":"W Campbell","year":"1965","unstructured":"Campbell, W. Clinical radiological investigations of the mandibular joints. Br. J. Radiol. 38, 401\u2013421 (1965).","journal-title":"Br. J. Radiol."},{"key":"89968_CR16","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/S1079-2104(05)80298-7","volume":"79","author":"JR Werther","year":"1995","unstructured":"Werther, J. R., Hall, H. D. & Gibbs, S. J. Disk position before and after modified condylotomy in 80 symptomatic temporomandibular joints. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 79, 668\u2013679 (1995).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"89968_CR17","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.bjps.2006.04.001","volume":"60","author":"SS Lai","year":"2007","unstructured":"Lai, S. S. et al. Skeletal changes after modified intraoral vertical ramus osteotomy for correction of mandibular prognathism. J. Plast. Reconstr. Aesthet. Surg. 60, 139\u2013145 (2007).","journal-title":"J. Plast. Reconstr. Aesthet. Surg."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89968-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89968-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89968-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T08:31:44Z","timestamp":1670056304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89968-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,17]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["89968"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-89968-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,17]]},"assertion":[{"value":"20 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10463"}}