Evaluation of Skeletal Changes after Mandibular Setback Surgery Using the NM-Low Z Plasty Technique in Skeletal Class III Patients

Abstract

Objective Bilateral sagittal split osteotomy (BSSO) is a standard mandibular setback procedure for skeletal class III patients. Our center has been using NM-Low Z plasty, a BSSO modification, since 2016. The study's objective was to evaluate skeletal changes in 38 skeletal class III patients following mandibular setback surgery using NM-Low Z plasty. With Dolphin Imaging software, three lateral cephalograms were traced and digitized: T0, T1, and T2. The distance between the B-point and the SN7 perpendicular line defined immediate changes after surgery (T1-T0) and stability after surgery (T2-T1). The reliability test included 6 cephalograms retraced after 2-week interval. At point B, the principal result was horizontal movement forward. Statistical Analysis The analysis used paired t-tests. Results The mean mandibular setback was 9.78 mm, and the mean skeletal relapse was 2.61 mm, or 26.69%. Statistical analysis showed postoperative differences (p < 0.05). Vertical measurement in B-SN7 reduced immediately and postoperatively. Conclusion Postoperatively, the mandible relapsed significantly forward and upward. Rotational relapse is a concern with NM-Low Z plasty in hypo-/normodivergent patients.