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Comparison of Postoperative Stability between Distraction Osteogenesis and Bilateral Sagittal Split Ramus Osteotomy in Mandibular Retrognathism  

You, Myung-Su (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University)
Lee, Jee-Ho (Department of Oral and Maxillofacial Surgery, Seoul Asan Hospital, College of Medicine, University of Ulsan)
Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.34, no.2, 2012 , pp. 100-105 More about this Journal
Abstract
Purpose: In general, the surgical treatment for mandibular retrognathism is represented by two methods, distraction osteogenesis (DO) and mandibular osteotomy surgery. The DO is mostly preferred when the degree of advancement of mandible is large. However, the postoperative stability of mandibular advancement using DO have not been actively investigated. Therefore, in the present study we have compared the postoperative stability between DO and bilateral sagittal split ramus osteotomy (BSSRO) in mandibular retrognathism. Methods: Seven patients who had been treated by DO and thirteen patients with BSSRO were included in this study. Serial lateral cephalograms were analyzed by manual tracing and the amount of the mandibular elongation was measured. To evaluate the postoperative stability, positional changes of the condylar position and B point were analyzed. Results: Mean amount of mandibular advancement was $6.51{\pm}3.57mm$ for BSSRO group and $12.43{\pm}4.35mm$ for DO group, respectively. There was no significant difference in age between the two groups (P>0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were $0.56{\pm}1.43mm$ horizontally and $0.72{\pm}1.61mm$ vertically for BSSRO group and $0.53{\pm}1.56mm$ horizontally and $0.56{\pm}1.75mm$ vertically for DO group, respectively. Mean change of distance from B point to Y-axis was $-1.76{\pm}0.83mm$ for BSSRO group and $-2.14{\pm}1.82mm$ for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05). Conclusion: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.
Keywords
Mandibular retrognathism; Distraction osteogenesis; BSSRO; Stability;
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1 Schreuder WH, Jansma J, Bierman MW, Vissink A. Distraction osteogenesis versus bilateral sagittal split osteotomy for advancement of the retrognathic mandible: a review of the literature. Int J Oral Maxillofac Surg 2007;36:103-10.   DOI   ScienceOn
2 Huang CS, Ross RB. Surgical advancement of the retrognathic mandible in growing children. Am J Orthod 1982; 82:89-103.   DOI   ScienceOn
3 Eggensperger N, Smolka W, Rahal A, Iizuka T. Skeletal relapse after mandibular advancement and setback in single- jaw surgery. J Oral Maxillofac Surg 2004;62:1486-96.   DOI   ScienceOn
4 Moore KE, Gooris PJ, Stoelinga PJ. The contributing role of condylar resorption to skeletal relapse following mandibular advancement surgery: report of five cases. J Oral Maxillofac Surg 1991;49:448-60.   DOI   ScienceOn
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   ScienceOn
6 van Strijen PJ, Breuning KH, Becking AG, Tuinzing DB. Stability after distraction osteogenesis to lengthen the mandible: results in 50 patients. J Oral Maxillofac Surg 2004;62: 304-7.   DOI   ScienceOn
7 McTavish J, Marucci DD, Bonar SF, Walsh WR, Poole MD. Does the sheep mandible relapse following lengthening by distraction osteogenesis? J Craniomaxillofac Surg 2000;28:251-7.   DOI   ScienceOn
8 Whitesides LM, Meyer RA. Effect of distraction osteogenesis on the severely hypoplastic mandible and inferior alveolar nerve function. J Oral Maxillofac Surg 2004;62:292-7.   DOI   ScienceOn
9 Epker BN, Wessberg GA. Mechanisms of early skeletal release following surgical advancement of the mandible. Br J Oral Surg 1982;20:175-82.   DOI
10 Tucker MR. Management of severe mandibular retrognathia in the adult patient using traditional orthognathic surgery. J Oral Maxillofac Surg 2002;60:1334-40.   DOI   ScienceOn
11 Vos MD, Baas EM, de Lange J, Bierenbroodspot F. Stability of mandibular advancement procedures: bilateral sagittal split osteotomy versus distraction osteogenesis. Int J Oral Maxillofac Surg 2009;38:7-12.   DOI   ScienceOn
12 Ow A, Cheung LK. Skeletal stability and complications of bilateral sagittal split osteotomies and mandibular distraction osteogenesis: an evidence-based review. J Oral Maxillofac Surg 2009;67:2344-53.   DOI   ScienceOn
13 Thygesen TH, Bardow A, Helleberg M, Norholt SE, Jensen J, Svensson P. Risk factors affecting somatosensory function after sagittal split osteotomy. J Oral Maxillofac Surg 2008;66: 469-74.   DOI   ScienceOn
14 Eggensperger N, Smolka K, Luder J, Iizuka T. Short- and long-term skeletal relapse after mandibular advancement surgery. Int J Oral Maxillofac Surg 2006;35:36-42.   DOI   ScienceOn
15 Walker DA. Management of severe mandibular retrognathia in the adult patient using distraction osteogenesis. J Oral Maxillofac Surg 2002;60:1341-6.   DOI   ScienceOn