Evaluation of Skeletal Relapse and Condylar Positional Changes Following Bimaxillary Orthognathic Surgery: A Three-Dimensional CBCT Study

Background: Bimaxillary orthognathic surgery is performed to correct dentofacial deformities and establish functional occlusion and facial balance. Postoperative skeletal relapse and condylar positional changes may influence the stability of surgical correction. Three-dimensional (3D) cone-beam computed tomography (CBCT) enables comprehensive evaluation of skeletal displacement and condylar adaptation over time. Aim: To evaluate postoperative skeletal stability and bilateral condylar positional changes following bimaxillary orthognathic surgery and to investigate the association between skeletal relapse and condylar translation and rotation Materials and Methods: This longitudinal observational study included 40 patients aged 18–38 years who underwent bimaxillary orthognathic surgery at a tertiary care centre between April 2024 and March 2026. The study population comprised 24 females and 16 males, with a mean age of 24.8 ± 5.1 years. CBCT images obtained preoperatively, immediately postoperatively, and at the 12-month follow-up were assessed. Skeletal changes were evaluated using the maxillary A-point and mandibular B-point, along with vertical skeletal measurements. Bilateral condylar translation was assessed along the anteroposterior (AP), superior–inferior (SI), and medial–lateral (ML) axes, while rotational changes were evaluated in terms of pitch, yaw, and roll. Statistical analyses were performed using International Business Machines Statistical Package for the Social Sciences (IBM SPSS) Statistics version 29.0. Paired statistical tests and correlation analyses were used as appropriate, with statistical significance established at p < 0.05. Conclusion: Longitudinal 3D CBCT assessment provides a systematic approach to evaluating postoperative skeletal stability and condylar adaptation following bimaxillary orthognathic surgery. Examining skeletal displacement alongside bilateral condylar translation and rotation may improve understanding of their potential relationship. The clinical significance of these radiographic changes should be interpreted in conjunction with occlusal stability and temporomandibular joint (TMJ) function.