Technical factors accounting for stability of a bilateral sagittal split osteotomy advancementWire osteosynthesis versus rigid fixation

Short- and long-term skeletal relapse after mandibular advancement surgery

“…Both gonion and the proximal segment returned to their individual preoperative position in the early postoperative period of 6 months. At the 26 19 1 year 5.0-6.0 6.0-8.3 GASSMANN et al 6 25 >6 months 6.6 >25.0 SIMMONS et al 21 same time, both B-point and pogonion advanced slightly further. This result suggests that not only inferior but also posterior dislocation of the condyles occurred as a result of the surgery, which postoperatively caused an additional forward movement of the mandible.…”

“…In our series of patients the mean amount of surgical movement (4.1 mm at B-point and 4.9 mm at pogonion) is slightly lower than reported in other studies on bilateral sagittal split mandibular advancement with rigid fixation ( Table 3). Most of the previous studies report a follow-up of 1 to 2 Relapse after mandibular advancement 39 years 6,7,10,13,[15][16][17][18]24,27,26,29 . After a corresponding postoperative period of 14 months, skeletal relapse of 1.2 mm at Bpoint and 1.5 mm at pogonion was measured in our study, amounting to 29% and 31% of surgical advancement, respectively.…”

“…Many studies have identified the magnitude of advancement as the major factor contributing to skeletal relapse 5,6,13,26,31 . It has been stated by the majority that large advancement tends to generate comparatively larger and more prolonged soft-tissue tensile forces.…”

The Effect of the Mandibular Fixation Method after Bilateral Sagittal Split Ramus Osteotomy on Postoperative Stability: A Literature Review

“…Despite the easiness of condyle repositioning with rigid techniques, condylar head remodeling is lower with non-rigid or semirigid techniques (5). However, some authors do not accept this concept; they believe that rigid techniques are the key factor of treatment success (6)(7)(8)(9). In this study, the results of the up-to-date papers were collected, which identify the effects of the fixation method on the post-operative results, in order to give readers a comprehensive view of the new concepts.…”

“…Furthermore, Moen et al described the insignificant skeletal changes that happen after mandibular advancement using the rigid fixation technique; meanwhile, however, he believed that the minor changes that happen after surgery are due to dental relapse (27). In 2000, Van Sickels et al showed that initial advancement, change in ramus in inclination, and change in the mandibular plane are the main factors influencing the long-term results of using any type of fixation technique (9). As mentioned before, there are not enough research articles about the comparative outcomes of different fixation methods for mandibular body fractures after BSSRO in Cl II patients.…”