Mandibular Stability After Sagittal Split Ramus Osteotomy With Hybrid Technique in Asymmetric Patients

Abstract

The hybrid technique after bilateral sagittal split ramus osteotomy is an internal fixation method using monocortical miniplates and additional bicortical positional screws. In this study, we analyzed the postoperative stability of 23 patients with mandibular asymmetry who underwent bilateral sagittal split ramus osteotomy and hybrid fixation with or without LeFort I osteotomy. Anatomical landmarks of the deviated and non-deviated sides of the jaw were established to measure the angle and distance to the reference plane in three-dimensional cone beam computed tomography images. We analyzed the positional changes and correlations of the reference points at preoperative (T1), postoperative 2 weeks (T2), and postoperative 1 year (T3). There were significant differences in preoperative position of the upper and lower molar cervix alveolar crest to the reference plane (U6-X and L6-X) and the condylion angles between deviated and non-deviated sides. Postoperatively (T2-T3), each reference point had no statistically significant positional change. Pearson correlation coefficient between the amount of menton deviation (ME-X at T1) and positional change of menton after surgery (T2-T3) was 0.30, and P value was 0.168. The hybrid fixation technique is an effective fixation method for achieving postoperative stability for mandibular asymmetry.

Treatment outcome and long-term stability of orthognathic surgery for facial asymmetry: A systematic review and meta-analysis

“…Supplementary Table 3 summarizes the NOS results. Most of the studies were assessed as moderate quality, 12 - 48 while a few were assessed as high quality. 14 , 49 - 62 The studies were classified as high quality when the comparability of cohorts was appropriately addressed based on the study design or analysis.…”

“…In a comprehensive review involving 44 studies, 12 - 43 , 49 - 60 77 outcome indicators were analyzed to assess skeletal symmetry before and after orthognathic surgery. The SMDs of skeletal symmetry according to one- and two-jaw surgery are shown in Figure 2 , with descriptions of the study groups and outcome variables in Table 3 .…”

Simultaneous Mandibular Anterior Segmental Osteotomy and Genioplasty: A Novel Technique

“…There are simple rules to follow to avoid any complication. At least 3 recommendations of utmost importance can be proposed to maintain optimal vascularization of the osteotomized segment [10][11][12][13] :…”

“…There are simple rules to follow to avoid any complication. At least 3 recommendations of utmost importance can be proposed to maintain optimal vascularization of the osteotomized segment10–13: Avoid any dissection of the buccal gingival attachment of the segment that will be mobilized. Never strip the lingual mucoperiosteal attachment from the osteotomized segment. Perform the horizontal subapical cut as low as possible to include maximal suprahyoid and genial musculature attachments. This region is the primary source of the collateral blood supply. …”

Estabilidade pós-operatória do método híbrido de fixação interna rígida da osteotomia sagital do ramo mandibular em cirurgias ortognáticas: uma revisão sistemática

“…Em seguida, um parafuso bicortical é colocado na região retromolar (8). A adição do parafuso bicortical posicional permite a manutenção do posicionamento espacial entre os segmentos distal e proximal, evitando assim alterações no posicionamento dos côndilos no período pós-operatório (68).…”