Changes of Transverse Mandibular Width in Set-Back Mandibular Surgery: Sagittal Split versus Intraoral Verticosagittal Osteotomy
- 1 Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
- 2 Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
- 3 Department of Pediatric Dentistry, Dental Branch, Islamic Azad University, Tehran, Iran
- 4 Dentist, Private Practice, Tehran, Iran
Abstract
Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral verticosagittal ramus osteotomy, it can minimize the movement of the proximal segment. The changes in the intergonal distance of mandible and the angle of the ramus flaring in two methods of osteotomy have been compared in this study. Materials and Methods: In this randomized clinical trial, included 60 patients (32 males) with mandibular prognathism and without any asymmetry were selected and divided into two groups (n = 30). One group underwent bilateral sagittal split ramus osteotomy technique to achieve mandibular setback and the other by the intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner-ramal angle in the transverse plane were measured on radiographs preoperatively and 1 and 12 weeks postoperatively. Data were analyzed using covariance test with the significance level set at P < 0.05. Results: Changes of intergonial width and inter-ramal angle was significant in both the 1 and 12-week radiographies taken post-operative in both groups. But no statistically significant difference was observed in the intergonial width and ramus flaring at the mentioned time points between the two groups (P > 0.1). Conclusion: Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle.
- Trauner, R. and Obwegeser, H. (1957) The Surgical Correction of Mandibular Prognathism and Retrognathia with Consideration of Genioplasty. Part I. Surgical Procedures to Correct Mandibular Prognathism and Reshaping of the Chin. Oral Surgery, Oral Medicine, Oral Pathology, 10, 677-689. https://doi.org/10.1016/S0030-4220(57)80063-2
- Epker, B.N., Stella, J.P. and Fish, L.C. (1996) Dentofacial Deformities: Integrated Orthodontic and Surgical correction. 2nd Ed., Mosby, London.
- Fonseca, R. (2017) Oral and Macxillofacial Surgery. 3rd Ed., Elsevier, St Louis.
- Karas, N.D., Boyd, S.B. and Sinn, D.P. (1990) Recovery of Neurosensory Function Following Orthognathic Surgery. Journal of Oral and Maxillofacial Surgery, 48, 124-134. https://doi.org/10.1016/S0278-2391(10)80199-5
- Agbaje, J.O., Salem, A.S., Lambrichts, I., Jacobs, R. and Politis, C. (2015) Systematic Review of the Incidence of Inferior Alveolar Nerve Injury in Bilateral Sagittal Split Osteotomy and the Assessment of Neurosensory Disturbances. International Journal of Oral & Maxillofacial Surgery, 44, 447-451. https://doi.org/10.1016/j.ijom.2014.11.010
- Miloro, M., Larsen, P.E., Ghali, G.E. and Waite, P.D. (2004) Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd Ed., BC Decker, Hamilton, London.
- Choung, P.H. (1992) A New Osteotomy for the Correction of Mandibular Prognathism: Techniques and Rationale of the Intraoral Verticosagittal Ramus Osteotomy. Journal of Cranio-Maxillo-Facial Surgery, 20, 153-162. https://doi.org/10.1016/S1010-5182(05)80390-7
- Fujimura, K., Segami, N., Sato, J., Kanayama, K., Nishimura, M. and Demura, N. (2004) Advantages of Intraoral Verticosagittal Ramus Osteotomy in Skeletofacial Deformity Patients with Temporomandibular Joint Disorders. Journal of Oral and Maxillofacial Surgery, 62, 1246-1252. https://doi.org/10.1016/j.joms.2004.01.026
- MahmoodHashemi, H. (2008) Evaluation of Intraoral Verticosagittal Ramus Osteotomy for Correction of Mandibular Prognathism. A 10 Year Study. Journal of Oral and Maxillofacial Surgery, 66, 509-512. https://doi.org/10.1016/j.joms.2007.03.033
- Fujimura, K., Segami, N. and Kobayashi, S. (2006) Anatomical Study of the Complications of Intraoral Vertico-Sagittal Ramus Osteotomy. Journal of Oral and Maxillofacial Surgery, 64, 384-389. https://doi.org/10.1016/j.joms.2005.11.009
- Sund, G., Eckerdal, O. and Astrand, P. (1983) Changes in the Temporomandibular Joint after Oblique Sliding Osteotomy of the Mandibular Rami. A Longitudinal Radiological Study. Journal of Maxillofacial Surgery, 11, 87-91. https://doi.org/10.1016/S0301-0503(83)80021-6