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Relapse after rigid fixation of mandibular advancement
Authors:J E Van Sickels  A J Larsen  W J Thrash
Abstract:In 19 subjects rigid fixation of bilateral sagittal split osteotomies was used for mandibular advancement. Five angles and four linear measurements were determined cephalometrically for two time intervals: before surgery to immediately after surgery (T1-T2), and immediately after surgery to six months to one year after surgery (T2-TL). A multiple regression analysis with a backward stepping procedure was used to determine relationships between relapse, as defined by the position of pogonion at T2-TL (PgT2) and B point during this same time interval (BT2). The only significant predictor of PgT2 was PgT1 (P less than 0.001) (amount of advancement of pogonion during the time interval T1-T2). When BT2 was examined, both the change in position of B point at T1-T2 (P less than 0.001) and the change in anterior facial height at T1-T2 (P less than 0.02) were significant predictors of relapse. There were no other predictors of relapse. Advancements of 6 to 7 mm or greater as measured at B or Pg deserve special attention as they were more predisposed to relapse. Methods for preventing relapse are discussed.
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