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. 2024 Sep 10;46(1):33.
doi: 10.1186/s40902-024-00444-7.

Changes in mandibular width and frontal-lower facial profile after orthognathic surgery using sagittal split ramus osteotomy with removal of internal bone interference in patients with class III skeletal malocclusion

In Jae Song  1 , Min Seong Kang  1 , Jung Han Lee  1 , Eun Yeong Bae  2 , Bok Joo Kim  1 , Chul Hoon Kim  1 , Jung Han Kim  3
Affiliations

Changes in mandibular width and frontal-lower facial profile after orthognathic surgery using sagittal split ramus osteotomy with removal of internal bone interference in patients with class III skeletal malocclusion

In Jae Song et al. Maxillofac Plast Reconstr Surg. .

Abstract

Background: The purpose of this study is to analyze changes in mandibular width and frontal view ramus inclination using cone beam CT in patients with skeletal class III malocclusion who underwent BSSRO, with the removal of bone interference between segments.

Methods: For all 20 subjects, cone-beam CT imaging was performed prior to surgery (T1), immediately post-surgery (T2), and 6 months after surgery (T3). Reorientation was performed using R2GATE software (MegaGen, Seoul, Korea). The gonion and antegonial notch were used as reference points in the sagittal view, and the most lateral point of the condyle head was used as the reference point in the frontal view. All measurements were recorded in the frontal view.

Results: Inter-gonial width decreased by 2.64 mm at T3-T2 (P < .001) and by 2.58 mm at T3-T1 (P < .05). Inter-antegonial width decreased by 1.75 mm at T3-T2 (P < .05) and by 3.5 mm at T3-T1 (P < .001). In the frontal view, the right ramus inclination based on the gonion increased by 2.07° at T3-T1 (P < .05). The left ramus inclination based on gonion increased by 2.45° at T2-T1 (P < .05) and by 3.94° at T3-T1 (P < .001). The right ramus inclination based on antegonial notch increased by 2.35° at T2-T1 (P < .05) and by 3.04° at T3-T1 (P < .01). The left ramus inclination based on antegonial notch increased by 2.73° at T2-T1 (P < .001) and by 3.18° at T3-T1 (P < .001).

Conclusions: During bilateral sagittal split osteotomy, removing bone interference between the proximal and distal segments results in a reduction of postoperative mandibular width and an increase in frontal view ramus inclination.

Keywords: Bone interference; Class III skeletal malocclusion; Mandibular width; Ramus inclination; SSRO.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Preoperative bone interference 3D images acquired by the FaceGide software (MegaGen)
Fig. 2
Fig. 2
Reference points
Fig. 3
Fig. 3
Measured variables
Fig. 4
Fig. 4
Changes in mandibular width
Fig. 5
Fig. 5
Bar graph for changes in mandibular width
Fig. 6
Fig. 6
Changes in frontal view ramus inclination based on gonion
Fig. 7
Fig. 7
Changes in frontal view ramus inclination based on antegonial notch
Fig. 8
Fig. 8
Bar graph for changes in frontal view ramus inclination
See this image and copyright information in PMC

References

    1. Ueki K, Marukawa K, Shimada M, Nakagawa K, Alam S, Yamamoto E (2006) Maxillary stability following Le Fort I osteotomy in combination with sagittal split ramus osteotomy and intraoral vertical ramus osteotomy: a comparative study between titanium miniplate and poly-l-lactic acid plate. J Oral Maxillofac Surg 64(1):74–80 10.1016/j.joms.2005.09.015 - DOI - PubMed
    1. Al-Gunaid T, Yamada K, Takagi R, Saito C, Saito I (2008) Postoperative stability of bimaxillary surgery in class iii patients with mandibular protrusion and mandibular deviation: a frontal cephalometric study. Int J Oral Maxillofac Surg 37(11):992–998 10.1016/j.ijom.2008.05.018 - DOI - PubMed
    1. Angle AD, Rebellato J, Sheats RD (2007) Transverse displacement of the proximal segment after bilateral sagittal split osteotomy advancement and its effect on relapse. J Oral Maxillofac Surg 65(1):50–59 10.1016/j.joms.2005.11.117 - DOI - PubMed
    1. Harris MD, Van Sickels JE, Alder M (1999) Factors influencing condylar position after the bilateral sagittal split osteotomy fixed with bicortical screws. J Oral Maxillofac Surg 57(6):650–4. discussion 654-5 10.1016/S0278-2391(99)90422-6 - DOI - PubMed
    1. Yoshida K, Rivera RS, Kaneko M, Kurita K (2001) Minimizing displacement of the proximal segment after bilateral sagittal split ramus osteotomy in asymmetric cases. J Oral Maxillofac Surg 59(1):15–18 10.1053/joms.2001.19264 - DOI - PubMed

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