Postoperative stability of two common ramus osteotomy procedures for the correction of mandibular prognathism: A randomized controlled trial |
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| Institution: | 1. Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg (Head: Prof. Dr. Dr. S. Otto), Ernst-Grube-Straße 40, 06120, Halle, Germany;2. Professor Emeritus of the Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, 06193, Petersberg, Germany;1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China;2. Department of Stomatology, Changhai Hospital, Shanghai, 200433, PR China;1. Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;2. Joint Research Department of Next-Generation Dental Materials Engineering, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;3. Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;1. Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan;2. Department of Oral and Maxillofacial Surgery, Kagoshima University Hospital, Japan;3. The Department of Oral Surgery, Faculty of Dental Medicine, Airlangga University, Indonesia;4. The 2nd Department of Oral and Maxillofacial Surgery, School & Graduate School of Dentistry, Osaka University, Japan;1. Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany;2. Cankiri Karatekin University, Department of Periodontology, Cankiri, Turkey |
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| Abstract: | The aim of this randomized controlled trial was to compare the skeletal stability between sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) in the treatment of mandibular prognathism. Patients presenting with mandibular prognathism and scheduled for orthognathic surgery were randomized into either the SSRO group or the IVRO group. Changes at B-point were assessed by serial tracing of lateral cephalograms, which were taken preoperatively, and at 2 weeks, 6 months, 1 year, and 2 years postoperatively. Ninety-eight patients were recruited, with 49 patients in each group. Between 2 weeks and 6 months postoperatively, there was significantly more surgical relapse in the horizontal direction (anterior movement) in the SSRO group when compared with the IVRO group (1.83 mm (SD 2.91 mm) vs 0.49 mm (SD 2.32 mm); p = 0.019). At 2 years, there was more surgical relapse in the horizontal direction in the SSRO group than in the IVRO group (0.27 mm (SD 0.34 mm) vs 0.10 mm (SD 0.29 mm); p = 0.014). There were also more absolute changes (irrespective of direction) at B-point in the SSRO group than in the IVRO group at postoperative 6 months, 1 year, and 2 years (p = 0.016, 0.049, and 0.045, respectively). The amounts of change at B-point as percentages of total mandibular setback were 1.3% and 3.5% in the IVRO group and SSRO group, respectively. There were no differences in vertical changes between the two groups at any time points. In conclusion, the horizontal stability at B-point was shown to be superior in the IVRO group compared with the SSRO group in the correction of mandibular prognathism during the 2-year follow-up. Although the exact clinical importance of this difference is unknown at this time, this possible benefit may be an important key factor when deciding which osteotomy technique to employ for mandibular setback. |
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| Keywords: | Orthognathic surgery Stability Mandibular prognathism Sagittal split ramus osteotomy Intraoral vertical subsigmoid osteotomy |
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