Comparison of postoperative stability of three rigid internal fixation techniques after sagittal split ramus osteotomy for mandibular advancement

Abstract

Introduction: The aim of this investigation was to compare the skeletal stability of three different rigid fixation methods after mandibular advancement.

Material and methods: Fifty-five class II malocclusion patients treated with the use of bilateral sagittal split ramus osteotomy and mandibular advancement were selected for this retrospective study. Group 1 (n = 17) had miniplates with monocortical screws, Group 2 (n = 16) had bicortical screws and Group 3 (n = 22) had the osteotomy fixed by means of the hybrid technique. Cephalograms were taken preoperatively, 1 week within the postoperative care period, and 6 months after the orthognathic surgery. Linear and angular changes of the cephalometric landmarks of the chin region were measured at each period, and the changes at each cephalometric landmark were determined for the time gaps. Postoperative changes in the mandibular shape were analyzed to determine the stability of fixation methods.

Results: There was minimum difference in the relapse of the mandibular advancement among the three groups. Statistical analysis showed no significant difference in postoperative stability. However, a positive correlation between the amount of advancement and the amount of postoperative relapse was demonstrated by the linear multiple regression test (p < 0.05).

Conclusion: It can be concluded that all techniques can be used to obtain stable postoperative results in mandibular advancement after 6 months.

Keywords: Mandibular osteotomy; Orthognathic surgery; Rigid internal fixation; Skeletal relapse.