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http://dx.doi.org/10.5125/jkaoms.2015.41.3.156

Stability of unilateral sagittal split ramus osteotomy for correction of facial asymmetry: long-term case series and literature review  

Lee, Seong-Geun (Ilsan Ye Dental Clinic)
Kang, Young-Hoon (Department of Oral and Maxillofacial Surgery, School of Medicine and Institute of Health Science, Gyeongsang National University)
Byun, June-Ho (Department of Oral and Maxillofacial Surgery, School of Medicine and Institute of Health Science, Gyeongsang National University)
Kim, Uk-Kyu (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University)
Kim, Jong-Ryoul (Department of Oral and Maxillofacial Surgery, Jaw and Face Surgery Center, On General Hospital)
Park, Bong-Wook (Department of Oral and Maxillofacial Surgery, School of Medicine and Institute of Health Science, Gyeongsang National University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.41, no.3, 2015 , pp. 156-164 More about this Journal
Abstract
Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries.
Keywords
Unilateral sagittal split ramus osteotomy; Functional facial asymmetry; Laterognathism; Temporomandibular joint;
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1 Trauner R, Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 1957;10:677-89.   DOI
2 Borstlap WA, Stoelinga PJ, Hoppenreijs TJ, van't Hof MA. Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part III--condylar remodelling and resorption. Int J Oral Maxillofac Surg 2004;33:649-55.   DOI
3 Wohlwender I, Daake G, Weingart D, Brandstätter A, Kessler P, Lethaus B. Condylar resorption and functional outcome after unilateral sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:315-21.   DOI
4 Falter B, Schepers S, Vrielinck L, Lambrichts I, Thijs H, Politis C. Occurrence of bad splits during sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:430-5.   DOI
5 Cutbirth M, Van Sickels JE, Thrash WJ. Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 1998;56:178-82.   DOI
6 Habets LL, Bezuur JN, Naeiji M, Hansson TL. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil 1988;15:465-71.   DOI
7 Snodell SF, Nanda RS, Currier GF. A longitudinal cephalometric study of transverse and vertical craniofacial growth. Am J Orthod Dentofacial Orthop 1993;104:471-83.   DOI
8 Kilic N, Kiki A, Oktay H. Condylar asymmetry in unilateral posterior crossbite patients. Am J Orthod Dentofacial Orthop 2008;133:382-7.   DOI
9 Cheong YW, Lo LJ. Facial asymmetry: etiology, evaluation, and management. Chang Gung Med J 2011;34:341-51.
10 Primozic J, Perinetti G, Richmond S, Ovsenik M. Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary, early, and late mixed dentition phases. Angle Orthod 2013;83:253-8.   DOI
11 Motamedi MH. Treatment of condylar hyperplasia of the mandible using unilateral ramus osteotomies. J Oral Maxillofac Surg 1996;54:1161-9.   DOI
12 Merkx MA, Van Damme PA. Condylar resorption after orthognathic surgery. Evaluation of treatment in 8 patients. J Craniomaxillofac Surg 1994;22:53-8.   DOI
13 Westermark A. LactoSorb resorbable osteosynthesis after sagittal split osteotomy of the mandible: a 2-year follow-up. J Craniofac Surg 1999;10:519-22.   DOI
14 Ozdemir R, Baran CN, Karagoz MA, Dogan S. Place of sagittal split osteotomy in mandibular surgery. J Craniofac Surg 2009;20:349-55.   DOI
15 Fujita T, Shirakura M, Koh M, Itoh G, Hayashi H, Tanne K. Changes in the lip-line in asymmetrical cases treated with isolated mandibular surgery. J Orthod 2013;40:313-7.   DOI
16 Rubens BC, Stoelinga PJ, Weaver TJ, Blijdorp PA. Management of malunited mandibular condylar fractures. Int J Oral Maxillofac Surg 1990;19:22-5.   DOI
17 Wong GB. Large odontogenic myxoma of the mandible treated by sagittal ramus osteotomy and peripheral ostectomy. J Oral Maxillofac Surg 1992;50:1221-4.   DOI
18 Harris MD, Van Sickels JE, Alder M. Factors influencing condylar position after the bilateral sagittal split osteotomy fixed with bicortical screws. J Oral Maxillofac Surg 1999;57:650-4.   DOI
19 Becking AG, Zijderveld SA, Tuinzing DB. Management of posttraumatic malocclusion caused by condylar process fractures. J Oral Maxillofac Surg 1998;56:1370-4.   DOI
20 Casap N, Zeltser R, Abu-Tair J, Shteyer A. Removal of a large odontoma by sagittal split osteotomy. J Oral Maxillofac Surg 2006;64:1833-6.   DOI