Open bite: stability after bimaxillary surgery--2-year treatment outcomes in 58 patients

Abstract

Stability after bimaxillary surgery to correct open bite malocclusion and mandibular retrognathism was evaluated on lateral cephalograms before surgery, 8 weeks post-operatively, and after 2 years. The 58 consecutive patients were treated to a normal occlusion and good facial aesthetics. Treatment included the orthodontic alignment of teeth by maxillary and mandibular fixed appliances, Le Fort I osteotomy, and bilateral sagittal split ramus osteotomy. Twenty-six patients also had a genioplasty. Intra-osseous wires or bicortical screws were used for fixation. Twenty-three patients had maxillo-mandibular fixation (MMF) for 8 weeks or more, six for 4-7 weeks, 14 for 1-3 weeks, and 15 had no fixation. At follow-up 2 years later, the maxilla remained unchanged and the mandible had rotated on average 1.4 degrees posteriorly. Seventeen patients had an open bite. Among them, eight patients had undergone segmental osteotomies. The relapse was mainly due to incisor proclination. The most stabile overbite was found in the group with no MMF after surgery.