The relationship between fixation method and early central condylar sagging after bilateral sagittal split ramus osteotomy in orthognathic surgery |
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| Affiliation: | 1. Istanbul University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Turgut Özal Millet Caddesi, 34093, Fatih, İstanbul, Turkey;2. Çapa Orthodontics Clinic, Şehremini Mah. Deniz Abdal Camii Sok. 23/A, 34104, Fatih, İstanbul, Turkey;3. Istanbul University Faculty of Dentistry, Department of Orthodontics, Turgut Özal Millet Caddesi, 34093, Fatih, İstanbul, Turkey;1. Department of Plastic and Reconstructive Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, China;2. Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA;3. Harvard Medical School, Boston, Massachusetts, USA;4. Harvard School of Dental Medicine, Boston, Massachusetts, USA;1. Fellow, Division of Oral and Maxillofacial Surgery, University of Kentucky, Chandler Medical Center University of Kentucky, Lexington, Kentucky, USA; ESHA Oral & Cranio-maxillofacial Surgery, Giza, Egypt;2. Provost Distinguished Service Professor, Assistant Dean of Hospital Dentistry, and Professor of Oral and Maxillofacial Surgery, Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, KY, USA;1. Department of Oral and Maxillofacial Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;2. Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands;3. Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;4. Department of Oral and Maxillofacial Surgery, Tjongerschans Hospital, Heerenveen, The Netherlands |
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| Abstract: | PurposeThere is no consensus about the ideal fixation methods and their effects on the condyle after the sagittal split ramus osteotomy (SSRO) procedure. The aim of this study was to compare the incidence, clinical presentation, and treatment of condylar sagging between different fixation methods following SSRO.MethodsPatients who underwent double jaw surgery between 2007 and 2017 were evaluated retrospectively. Mandibular fixation was maintained using one of three different options: a miniplate and a single bicortical screw, three bicortical screws, or a single bicortical screw. Some patients had malocclusion relapse in the early postoperative period due to condylar sagging, and needed reoperation. The reoperated condylar sagging patients were analysed statistically with respect to their fixation methods.Results233 patients (134 females, 99 males) with a mean age of 23.3 years were enrolled in the study. The patients fixated with a single bicortical screw had lower revision surgery rates than those with three bicortical screws or with miniplate with a single bicortical screw (p = 0.034 and p = 0.032, respectively). These differences in central condylar sagging with a need for revision were statistically significant.ConclusionAlthough a miniplate and a single bicortical screw and three bicortical screws are widely used after SSRO, if the priority is to avoid sagging then it seems that a single screw should be preferred for osteosynthesis. |
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| Keywords: | Condylar sag Double jaw surgery Orthognathic surgery Rigid fixation Sagittal split ramus osteotomy Single screw |
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