Stabilisation of sagittal split set-back osteotomies with miniplates: a prospective, multicentre study with 2-year follow-up

• Published in: International journal of oral and maxillofacial surgery Vol. 34; no. 5; pp. 487 - 494
• Main Authors: Borstlap, W.A., Stoelinga, P.J.W., Hoppenreijs, T.J.M., van’t Hof, M.A.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.07.2005; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Bone Plates; Bone Remodeling - physiology; Bone Resorption - etiology; Cephalometry; Dental Occlusion; Dentistry; Female; Follow-Up Studies; Humans; Male; Mandible - pathology; Mandible - surgery; Mandibular Condyle - diagnostic imaging; Mandibular Condyle - physiopathology; Mandibular Nerve - physiopathology; Medical sciences; Middle Aged; Orthopedic surgery; Osteotomy - instrumentation; Osteotomy - methods; Otorhinolaryngology. Stomatology; Paresthesia - etiology; Patient Satisfaction; Prospective Studies; Radiography, Panoramic; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Temporomandibular Joint - physiopathology; Temporomandibular Joint Disorders - etiology; Prospective; Treatment; Follow up study; Osteotomy; Stomatology; Surgery; Plate
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2005.01.007

The aim of this study was to assess post-operative stability of bilateral sagittal split set-back osteotomies using two miniplates and clinical parameters including nerve function, TMJ function, occlusal relapse and patient satisfaction. The stability was measured on cephalometric radiographs and possible condylar alterations on orthopantomograms. This prospective study implied a 2-year follow-up on a group of 24 patients. The same protocol was used at six participating institutions at which the patients were treated. A stable occlusion without appreciable relapse was seen in 91% after 2-year follow-up. Only two patients in this study had mild occlusal relapse. The mean skeletal horizontal relapse at pogonion of the whole group, after 2 years was 1.1 mm and appeared to be directed backwards. At occlusal level, however, the mean relapse was 1.2 mm forwards. The function of the inferior alveolar nerve 2 years post-operatively was reported to be normal in approximately 70% of the patients, yet 80% had no complaints about nerve dysaesthesia. In approximately 21% of the patients, signs and symptoms of TMJ dysfunction had disappeared. Another group (10%), however, without pre-operative signs and symptoms of TMJ dysfunction developed these signs or symptoms post-operatively. No condylar remodelling or resorption was seen in this group of patients. The sagittal split set-back osteotomy fixed with miniplates appeared to be a relatively save and reliable procedure giving rise to adequate results and a high degree of patients satisfaction.