Bilateral Sagittal Split Ramus Osteotomy Versus Distraction Osteogenesis for Advancement of the Retrognathic Mandible

Al‐Moraissi, Essam Ahmed; Ellis, Edward

doi:10.1016/j.joms.2015.01.003

Cited by 26 publications

(23 citation statements)

References 51 publications

(36 reference statements)

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“…Skeletal relapse after BSSO for mandibular advancement is a complex multifactorial phenomenon, where factors as the amount of advancement, the type and material of fixation, low and high mandibular plane angle, condylar resorption, control of the proximal segment, soft tissue and muscle tension, remaining growth and remodelling, skills and experience of the surgeon may contribute to skeletal relapse [ 24-26 ].…”

Section: Discussionmentioning

confidence: 99%

“…The potential promise of distraction osteogenesis is that because of the lengthening of the mandible occurs slowly, the soft tissue stretch associated with the lengthening can be more readily accommodated to the masticatory system. Moreover, distraction osteogenesis reduces the incidence of neurosensory disturbances of the inferior alveolar nerve after advancement of the retrognathic mandible compared with BSSO [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

Schwartz¹,

Rodrigo-Domingo²,

Jensen

2016

JOMR

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ObjectivesThe aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type.Material and MethodsA total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm) measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1), 8 weeks postoperatively (T2), and 18 month postoperatively (T3). B-point and pogonion (Pog) was used to measure the skeletal relapse and the mandibular plane angle (MP-angle) was used to determine the vertical facial type.ResultsThe mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog).ConclusionsThe present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

Schwartz¹,

Rodrigo-Domingo²,

Jensen

2016

JOMR

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“…One of the advantages of Balcony techniques is avoidance of extra depth in mentolabial fold which makes unaesthetic appearance in routine techniques especially in short-faced patients with deep mentolabial fold and everted lower lip [8, 9]. …”

Section: Discussionmentioning

confidence: 99%

Balcony genioplasty: a novel technique for better esthetic results in patients with deep mentolabial fold

Keyhan¹,

Cheshmi

Fallahi

et al. 2019

Maxillofac Plast Reconstr Surg

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Background To introduce a novel technique for advancement genioplasty helping surgeons to avoid soft tissue difficulties especially in short-faced patients with deep mentolabial fold and everted lower lip. Case presentation In a trapezius-shaped, osteotomy was performed in the chin region. The mobilized segment was advanced, and the existing gap was grafted using interpositional allograft materials. Each side had been fixated by three-hole plates and two screws. The outcomes revealed no change in lower anterior teeth vitality. The patients did not report any changes of sensation in lower lip and chin either. The measurements indicated no increase in depth of mentolabial fold in patients undergoing this surgical technique. The postoperative evaluation showed a successful esthetic outcome for the patient and the surgeon concurrently. Conclusion Based on our experience, the authors concluded that the Balcony technique is a simple and reliable procedure for patients with a deep mentolabial fold.

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“…The amount of mandibular advancement required exceeded 10 mm. The second option was rejected because, compared with BSSO, mandibular DO significantly reduces the incidence of neurosensory disturbance of the inferior alveolar nerve and the risk of relapse is lower in the case of large mandibular advancement (> 7 mm) [ 9 , 10 ]. It has been suggested that the smallest preoperative cross-sectional area of the upper airway should be considered for preoperative selection of the maxilla or mandible, or both, for advancement because there is a significant relationship between the narrowest cross-section of the upper airway and the probability of OSA [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…It remains unclear how to achieve a stable result for a patient who requires a large mandibular advancement [ 9 , 10 ]. In recent times, skeletal anchorage, for example, by means of miniscrews, has been widely used to enhance anchorage in craniofacial surgery applications [ 11 – 13 ] because it has been reported that use of such devices after mandibular setback surgery helps to prevent an increase in lower facial height [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report

et al. 2017

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BackgroundWe describe the case of a 16-year-old female patient with micrognathia, temporomandibular joint (TMJ) ankylosis, and obstructive sleep apnea, who was treated with mandibular distraction osteogenesis (DO) combined with sliding genioplasty, using skeletal anchorage.Case presentationWe first performed interpositional arthroplasty, in which an interposition of fascia temporalis and surrounding fat tissue was inserted into the defect after bilateral condylectomy, increasing the maximum mouth opening from 5.0 to 32.0 mm. Subsequently, orthodontic treatment and advancement of the mandible were carried out by mandibular DO, using miniscrews and miniplates. Finally, sliding genioplasty was performed to bring the tip of the mandible forward. The total amount of mandibular advancement at the menton was 16.0 mm. An improved facial appearance and good occlusion were eventually achieved, and the apnea-hypopnea index decreased from 37.1 to 8.7. There was no obvious bone resorption or pain in the temporomandibular region, limited mouth opening (maximum mouth opening: 33.0 mm), myofascial pain or headache, downward rotation of the mandible, or lateral shift of mandibular position evident at 5 years and 6 months after mandibular DO.ConclusionMandibular DO using skeletal anchorage with intermaxillary elastics is useful for preventing extrusion of the upper and lower anterior teeth, thereby preventing rotation of the mandible. In addition, mandibular DO combined with sliding genioplasty is effective at improving both dentofacial deformities and impaired respiratory function.

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Bilateral Sagittal Split Ramus Osteotomy Versus Distraction Osteogenesis for Advancement of the Retrognathic Mandible

Cited by 26 publications

References 51 publications

Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

Balcony genioplasty: a novel technique for better esthetic results in patients with deep mentolabial fold

Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report

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