Stability of unilateral sagittal split ramus osteotomy for correction of facial asymmetry: long-term case series and literature review

Lee, Seong-Geun; Kang, Young‐Hoon; Byun, June‐Ho; Kim, Uk-Kyu; Kim, Jongryoul; Park, Bong-Wook

doi:10.5125/jkaoms.2015.41.3.156

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…In reports of patients treated with USSO, the patients did not exhibit TMJ dysfunction, pain, limited mouth opening following surgery, or evidence of condylar resorption [30,31]. In the present study, similar results were found but the reported symptoms were not quantified for level of severity.…”

Section: Discussionsupporting

confidence: 83%

Unilateral sagittal split osteotomy: effect on mandibular symmetry in the treatment of class III with laterognathia

2020

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The bilateral sagittal split osteotomy is considered the standard surgery to correct facial asymmetries. More recently, unilateral sagittal split osteotomy (USSO) was used to treat such malocclusions. Aim: To assess facial symmetry following USSO in the treatment of class III laterognathia. Methods: Frontal facial photographs of four groups of patients were assessed: (1) pre-surgical group (n = 30) with skeletal asymmetry, (2) postsurgical group assessing patients of the first group 2 years after USSO, (3) control group (n = 30) of patients judged to have harmonious facial norms, and (4) mirrored group (n = 30) in which the control photographs were altered by duplicating the right half side of the face to replace the left half, thus creating perfectly symmetrical faces. All 120 photographs were distributed to 40 expert orthodontists to evaluate and score facial symmetry using the visual analog scale. Skin sensitivity and temporomandibular joint (TMJ) disorders were also assessed clinically pre and postsurgically. Results: Statistically significant differences were observed between the pre-surgical group and each of the postsurgical and control groups (p < 0.001). The control and postsurgical groups received similar scores of symmetry (p = 0.774). The mirrored group received statistically significantly higher symmetry scores than either of the control or the postsurgical groups (p < 0.001). A reduction in TMJ disorders was noted after USSO and all patients reported normal skin sensation 2 years post-surgery. Conclusion: When indicated, USSO is a dependable and practical surgical approach to correct facial asymmetries associated with class III malocclusion.

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Section: Discussionsupporting

confidence: 83%

Unilateral sagittal split osteotomy: effect on mandibular symmetry in the treatment of class III with laterognathia

2020

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“…SSO is a well-established procedure in the field of maxillofacial surgery. Although its main use lies in the orthognathic field, it can be a great tool in selected trauma cases [8][9][10][11][12]. For this procedure, the placement of dental implants to restore dentition is unnecessary because of the new preplanned occlusion employing existing teeth.…”

Section: Discussionmentioning

confidence: 99%

“…It is applicable in mandibular advancements, setbacks, ramus elongation, and all types of angular movements. However, it can be a great tool in the secondary treatment of the mandible fractures, e.g., the treatment of malocclusion resulting from condylar fractures with the shortening of the mandibular ramus [8,9] and reconstruction procedures of the mandible [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Secondary Treatment of Mandibular Bone Fracture Using Sagittal Split Osteotomy and Segmentation of the Mandible: A Case Report

Grab,

Chloupek,

Nowocień

et al. 2023

Reports

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The secondary treatment of mandibular bone fractures poses a great challenge due to the complexity of several factors, such as incorrect primary fracture repositioning, inadequate internal fixation, nonunion, necrosis, local inflammation and infection, tooth loss, and malocclusion, serving as obstacles encountered by surgical teams. The aim of this case report is to detail the planning process, surgical technique, and outcome of the secondary treatment of the post-traumatic deformation, bone exposure, and partial necrosis of the mandible. The new approach described herein incorporated 3D planning and printing procedures, employing surgical techniques such as the segmentation of the mandible with unilateral sagittal split osteotomy and the vertical osteotomy of the mandibular body. New, stable occlusion; appropriate spatial relations; and proper osteosynthesis of the mandible were achieved. The encouraging results obtained demonstrate that the described method can be incorporated in similar cases of the secondary treatment of mandibular fractures and possibly lead to shorter hospitalization and convalescence and lower the associated costs.

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“…It is necessary to clarify to what extent mandibular deviation can be corrected by USSRO with stable postoperative outcomes. In the study by Lee, S., et al, 7-mm unilateral mandibular movement after USSO would rotate the mandibular condyle 3° to 4° in nonosteotomy side without influencing TMJ function [27]. However, Beukes, J., et al suggested that USSRO should only be performed for small mandibular asymmetries of less than 5 mm [2].…”

Section: Discussionmentioning

confidence: 99%

Comparison of condylar morphology changes and position stability following unilateral and bilateral sagittal split mandibular ramus osteotomy in patients with mandibular prognathism

Han

Feng

et al. 2019

Head Face Med

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Background Unilateral sagittal split ramus osteotomy (USSRO) is not widely used given the postoperative instability caused by the inevitable rotation of the mandibular segment during surgery. However, the influence of mandibular movement on the condylar morphology and position stability has not been completely explored. The aim of the study was to quantitatively evaluate the effect of USSRO on the condylar surface morphology changes and postoperative stability in patients with mandibular lateral prognathism and compare these findings with the classic bilateral sagittal split ramus osteotomy (BSSRO). Patients/methods This was a retrospective study involving 134 patients with mandibular lateral prognathism who received USSRO ( n = 56) and BSSRO ( n = 78) surgery. Here, cone beam computed tomography (CBCT) was performed before surgery (T0), immediately after surgery (T1), and 1 year postoperatively (T2). Differences of condylar sizes, condylar surface deviation, and mandibular positioning parameters (dental midline deviation, SNB, SN-MP) were calculated from T0 to T2. Comparisons were performed at the deviated side or nondeviated side of condyles between the USSRO and BSSRO groups. The relation between the dental midline deviation and condylar surface morphology changes from T0 to T2 were investigated. Results Condylar surface morphology changes at the deviated side of temporomandibular joint (TMJ) before and 1 year after the surgery were significantly different between the USSRO and BSSRO groups. The dental midline deviation was related to the changes of condylar volume, surface size and surface deviation at the deviated side of TMJ in patients following USSRO. No significant difference was noted between the USSRO and BSSRO groups for postoperative condylar surface morphology changes at the nondeviated side. In both groups, significant differences between T0 and T1 and no significant difference between T1 and T2 were noted for all of the mandibular positioning parameters. Conclusions Both BSSRO and USSRO exhibit favorable postoperative stability in the correction of mandibular prognathism. After USSRO surgery, condylar surface changes occurred at the deviated side of the TMJ, and the dental midline deviation was closely related to the changes of condylar surface morphology. USSRO represents a stable alternative for minor asymmetric mandibular prognathism correction with the advantages of reduced operating time and surgical trauma.

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Stability of unilateral sagittal split ramus osteotomy for correction of facial asymmetry: long-term case series and literature review

Cited by 10 publications

References 19 publications

Unilateral sagittal split osteotomy: effect on mandibular symmetry in the treatment of class III with laterognathia

Unilateral sagittal split osteotomy: effect on mandibular symmetry in the treatment of class III with laterognathia

Secondary Treatment of Mandibular Bone Fracture Using Sagittal Split Osteotomy and Segmentation of the Mandible: A Case Report

Comparison of condylar morphology changes and position stability following unilateral and bilateral sagittal split mandibular ramus osteotomy in patients with mandibular prognathism

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