Comparative Study of Skeletal Stability Between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation After Bilateral Sagittal Split Ramus Osteotomy: an 18 Months Retrospective Study

Overview

Journal J Oral Maxillofac Res

Date 2014 May 7

PMID 24800052

Citations 3

Authors

Jens Hartlev

Erik Godtfredsen

Niels Trolle Andersen

Thomas Jensen

Affiliations

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Abstract

Objectives: The purpose of the present study was to evaluate skeletal stability after mandibular advancement with bilateral sagittal split osteotomy.

Material And Methods: Twenty-six patients underwent single-jaw bilateral sagittal split osteotomy (BSSO) to correct skeletal Class II malocclusion. One group (n = 13) were treated postoperatively with skeletal elastic intermaxillary fixation (IMF) while the other group (n = 13) where threated without skeletal elastic IMF.

Results: The mean advancement at B-point and Pog in the skeletal elastic IMF group was 6.44 mm and 7.22 mm, respectively. Relapse at follow-up at B-point was -0.74 mm and -0.29 mm at Pog. The mean advancement at B-point and Pog in the no skeletal elastic IMF group was 6.30 mm and 6.45 mm, respectively. Relapse at follow-up at B-point was -0.97 mm and -0.86 mm at Pog. There was no statistical significant (P > 0.05) difference between the skeletal IMF group and the no skeletal group regarding advancement nor relapse at B-point or Pog.

Conclusions: Bilateral sagittal split osteotomy is characterized as a stable treatment to correct Class II malocclusion. This study demonstrated no difference of relapse between the skeletal intermaxillary fixation group and the no skeletal intermaxillary fixation group. Because of selection-bias and the reduced number of patients it still remains inconclusive whether to recommend skeletal intermaxillary fixation or not in the prevention of relapse after mandibular advancement.

Citing Articles

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Biomechanical Analysis of the Forces Exerted during Different Occlusion Conditions following Bilateral Sagittal Split Osteotomy Treatment for Mandibular Deficiency.

Chang Y, Chan M, Hsu J, Hsiao H, Su K Appl Bionics Biomech. 2019; 2019:4989013.

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Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation.

Schwartz K, Rodrigo-Domingo M, Jensen T J Oral Maxillofac Res. 2016; 7(2):e5.

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References

Kierl M, NANDA R, Currier G . A 3-year evaluation of skeletal stability of mandibular advancement with rigid fixation. J Oral Maxillofac Surg. 1990; 48(6):587-92. DOI: 10.1016/s0278-2391(10)80471-9. View

Joss C, Vassalli I . Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. J Oral Maxillofac Surg. 2009; 67(2):301-13. DOI: 10.1016/j.joms.2008.06.060. View

Mobarak K, Espeland L, Krogstad O, Lyberg T . Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses. Am J Orthod Dentofacial Orthop. 2001; 119(4):368-81. DOI: 10.1067/mod.2001.110983. View

Joss C, Thuer U . Stability of the hard and soft tissue profile after mandibular advancement in sagittal split osteotomies: a longitudinal and long-term follow-up study. Eur J Orthod. 2007; 30(1):16-23. DOI: 10.1093/ejo/cjm080. View

Eggensperger N, Smolka K, Luder J, Iizuka T . Short- and long-term skeletal relapse after mandibular advancement surgery. Int J Oral Maxillofac Surg. 2005; 35(1):36-42. DOI: 10.1016/j.ijom.2005.04.008. View

Rustemeyer J, Martin A . Assessment of soft tissue changes by cephalometry and two-dimensional photogrammetry in bilateral sagittal split ramus osteotomy cases. J Oral Maxillofac Res. 2014; 2(3):e2. PMC: 3886076. DOI: 10.5037/jomr.2011.2302. View

Komori E, Aigase K, Sugisaki M, Tanabe H . Skeletal fixation versus skeletal relapse. Am J Orthod Dentofacial Orthop. 1987; 92(5):412-21. DOI: 10.1016/0889-5406(87)90262-9. View

Karlsen A . Craniofacial growth differences between low and high MP-SN angle males: a longitudinal study. Angle Orthod. 1995; 65(5):341-50. DOI: 10.1043/0003-3219(1995)065<0341:CGDBLA>2.0.CO;2. View

Proffit W, Turvey T, Phillips C . The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med. 2007; 3:21. PMC: 1876453. DOI: 10.1186/1746-160X-3-21. View

10.

Bailey L, Cevidanes L, Proffit W . Stability and predictability of orthognathic surgery. Am J Orthod Dentofacial Orthop. 2004; 126(3):273-7. PMC: 3681098. DOI: 10.1016/S0889540604005207. View

11.

Eggensperger N, Smolka W, Rahal A, Iizuka T . Skeletal relapse after mandibular advancement and setback in single-jaw surgery. J Oral Maxillofac Surg. 2004; 62(12):1486-96. DOI: 10.1016/j.joms.2004.07.007. View

12.

Gotfredsen E, Kragskov J, Wenzel A . Development of a system for craniofacial analysis from monitor-displayed digital images. Dentomaxillofac Radiol. 1999; 28(2):123-6. DOI: 10.1038/sj/dmfr/4600420. View

13.

Blomqvist J, Ahlborg G, Isaksson S, Svartz K . A comparison of skeletal stability after mandibular advancement and use of two rigid internal fixation techniques. J Oral Maxillofac Surg. 1997; 55(6):568-74; discussion 574-5. DOI: 10.1016/s0278-2391(97)90486-9. View

14.

Ellis 3rd E, Gallo W . Relapse following mandibular advancement with dental plus skeletal maxillomandibular fixation. J Oral Maxillofac Surg. 1986; 44(7):509-15. DOI: 10.1016/s0278-2391(86)80090-8. View

15.

Kahnberg K, Kashani H, Owman-Moll P . Sagittal split advancement osteotomy: comparison of the tendency to relapse after two different methods of rigid fixation. Scand J Plast Reconstr Surg Hand Surg. 2007; 41(4):167-72. DOI: 10.1080/02844310701270299. View

16.

Aydil B, Ozer N, Marsan G . Facial soft tissue changes after maxillary impaction and mandibular advancement in high angle class II cases. Int J Med Sci. 2012; 9(4):316-21. PMC: 3384840. DOI: 10.7150/ijms.4247. View

17.

Moen K, Wisth P, Skaale S, Boe O, Tornes K . Dental or skeletal relapse after sagittal split osteotomy advancement surgery? Long-term follow-up. J Oral Maxillofac Surg. 2011; 69(11):e461-8. DOI: 10.1016/j.joms.2011.02.086. View

18.

Rubens B, Stoelinga P, Blijdorp P, Schoenaers J, Politis C . Skeletal stability following sagittal split osteotomy using monocortical miniplate internal fixation. Int J Oral Maxillofac Surg. 1988; 17(6):371-6. DOI: 10.1016/s0901-5027(88)80066-3. View

19.

Hunsuck E . A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg. 1968; 26(4):250-3. View

20.

Burstone C, James R, Legan H, Murphy G, Norton L . Cephalometrics for orthognathic surgery. J Oral Surg. 1978; 36(4):269-77. View