Vertical Ramus Versus Sagittal Split Osteotomies: Comparison of Stability After Mandibular Setback

• Published in: Journal of oral and maxillofacial surgery Vol. 66; no. 6; pp. 1138 - 1144
• Main Authors: Yoshioka, Izumi, DDS, PhD, Khanal, Amit, BDS, PhD, Tominaga, Kazuhiro, DDS, PhD, Horie, Akihisa, DDS, PhD, Furuta, Norihiko, DDS, PhD, Fukuda, Jinichi, DDS, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2008; Elsevier
• Subjects: Adolescent; Adult; Analysis of Variance; Biological and medical sciences; Cephalometry; Dentistry; Female; Humans; Jaw Fixation Techniques - instrumentation; Male; Malocclusion, Angle Class III - surgery; Mandible - surgery; Medical sciences; Oral Surgical Procedures - methods; Orthopedic surgery; Osteotomy - methods; Otorhinolaryngology. Stomatology; Prognathism - surgery; Prospective Studies; Recurrence; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Vertical; Mandible; Stability; Treatment; Osteotomy; Stomatology; Surgery; Comparative study
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2007.09.008

Purpose Intraoral vertical ramus osteotomy (IVRO) offers some advantages over sagittal split ramus osteotomy (SSRO) for treatment of the prognathic patient. The purpose of this study was to compare the postoperative changes of proximal and distal segments after IVRO and SSRO with semirigid internal fixation. Patients and Methods Thirty Japanese adults with a diagnosis of prognathic mandible were randomized to undergo either IVRO (n = 15) or SSRO (n = 15) according to an adaptive random assignment procedure. The postoperative changes of the proximal and distal segments were assessed with posteroanterior and lateral cephalograms. Results Compared with the SSRO group, the B-point and pogonion moved significantly posteriorly and inferiorly in the IVRO group from 1 month to 3 months after surgery. At 1 year after surgery, there was no significant difference between the 2 groups in the horizontal and vertical stability of the B-point and the pogonion. In the IVRO group, the gonion deviated significantly laterally from 1 week until 1 month after surgery as compared with that of the SSRO group. There was a significant correlation between the amount of setback and the amount of lateral gonial deviation in the IVRO group from 1 week to 1 year after surgery. Conclusions Although in IVRO cases, distal segments moved posteriorly and inferiorly immediately after the release of maxillomandibular fixation, the stability after IVRO is equal to that after SSRO with semirigid internal fixation.