Comparative study of skeletal stability between bicortical resorbable and titanium screw fixation after sagittal split ramus osteotomy for mandibular prognathism |
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| Authors: | Jun-Young Paeng Jongrak Hong Chang-Soo Kim Myung-Jin Kim |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery (Head: Prof. Chang-Soo Kim), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;2. Department of Oral and Maxillofacial Surgery (Head: Prof. Jin-Young Choi), School of Dentistry, Seoul National University, Seoul, Republic of Korea;1. Department of Pediatric Orthopedic Surgery and Microsurgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain;2. Orthopaedic Surgery Department, Universitat de Barcelona, Barcelona, Spain;3. Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.;4. Unidad Cirugía Artroscópica, Hospital Vhitas San José, Vitoria-Gasteiz, Spain;5. Pediatric Orthopedic Surgery Department, Hôpital des Enfants, Toulouse, France;1. Resident, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;2. Department Head, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;3. Staff Member, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;4. Staff Member, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;6. Staff Member, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;5. Professor, Division of Maxillofacial Surgery, Department of Surgery, GH St John, Bruges-Ostend, Belgium;1. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan;2. Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan;1. Posnick Center for Facial Plastic Surgery, Georgetown University, Washington, DC, USA;2. School of Dentistry, University of Maryland, Baltimore, MD, USA;3. Howard University College of Dentistry, Washington, DC, USA;1. Posnick Center for Facial Plastic Surgery, Chevy Chase, MD, USA;2. Georgetown University, Washington, DC, USA;3. University of Maryland School of Dentistry, Baltimore, Maryland, USA;4. Oral and Maxillofacial Surgery, Howard University College of Dentistry, Washington, DC, USA;5. Past Chief Resident, Howard University Hospital, Washington, DC, USA;6. Currently Private Practice, Stockton and Modesto, California, USA;7. Currently Private Practice, Houston, Texas, USA |
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| Abstract: | IntroductionResorbable screw fixation for orthognathic surgery is widely used in oral and maxillofacial surgery and has several advantages. However, surgeons are concerned about using resorbable screws in orthognathic surgery because of possible postoperative complications such as relapse, screw fracture, and infection. The purpose of this study was to evaluate the skeletal stability of bicortical resorbable screw fixation after sagittal split ramus osteotomies for mandibular prognathism.Materials and methodsThis study included 25 patients who underwent mandibular setback surgery fixed with resorbable screws after sagittal split osteotomy at the Department of Oral and Maxillofacial Surgery at Seoul National University Dental Hospital. Five resorbable screws (Inion CPS®, Inion Ltd., Finland) were applied bicortically at each osteotomy site via a transbuccal approach. No rigid intermaxillary fixation was applied on the first postoperative day. Passive mouth opening exercises were allowed, using two light, rubber elastics for guidance. The control group was 25 patients fixed with four titanium screws. The follow-up period was 12–22 months (mean 17.8 months). Postoperative skeletal changes on lateral cephalometric radiographs were analyzed and compared between the two groups preoperatively, immediately postoperatively, and 6 months postoperatively.ResultsThe average setback was 6.9 mm and no major intraoperative complications occurred. One patient experienced infection immediately after surgery that was controlled uneventfully. The data did not demonstrate any significant difference in postoperative skeletal stability between the two groups. Differences between the immediate postoperative state and 6 months after surgery were not significant. In earlier cases, especially for patients with severe mandibular prognathism, immediate postoperative elastic traction was needed for stable occlusal guidance.ConclusionsThe results of this study indicate that bicortical resorbable screws offer a clinically stable outcome for the fixation of mandibular sagittal split osteotomies in mandibular prognathism. However the resorbable screws showed less stable results vertically than the titanium screws. |
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