An automated method for assessing condyle head changes in patients with skeletal class II malocclusion based on CBCT images.

OBJECTIVES: Currently, there is no reliable automated measurement method to study the changes in the condylar process after orthognathic surgery. Therefore, this study proposes an automated method to measure condylar changes in patients with skeletal class II malocclusion following surgical-orthodontic treatment.

METHODS: Cone-beam computed tomography (CBCT) scans from 48 patients were segmented using the nnU-Net network for automated maxillary and mandibular delineation. Regions unaffected by orthognathic surgery were selectively cropped. Automated registration yielded condylar displacement and volume calculations, each repeated three times for precision. Logistic regression and Linear regression were used to analyze the correlation between condylar position changes at different time points.

RESULTS: The Dice score for the automated segmentation of the condyle was 0.971. The Intraclass correlation coefficients (ICCs) for all repeated measurements ranged from 0.93 to 1.00. The results of the automated measurement showed that 83.33% of patients exhibited condylar resorption occurring six months or more after surgery. Logistic regression and Linear regression indicated a positive correlation between counterclockwise rotation in the Pitch plane and condylar resorption(p < 0.01). And a positive correlation between the rotational angles in both three planes and changes in the condylar volume at six months after surgery(p ≤ 0.04).

CONCLUSIONS: This study's automated method for measuring condylar changes shows excellent repeatability. Skeletal class II malocclusion patients may experience condylar resorption after bimaxillary orthognathic surgery, and this is correlated with counterclockwise rotation in the sagittal plane.

ADVANCES IN KNOWLEDGE: This study proposes an innovative multi-step registration method based on CBCT, and establishes an automated approach for quantitatively measuring condyle changes post-orthognathic surgery. This method opens up new possibilities for studying condylar morphology.