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Skeletal stability after mandibular advancement with rigid versus wire fixation
C Dolce1, J E Van Sickels, R A Bays
1Department of Orthodontics, University of Florida, Gainesville, USA. cdolce@dental.ufl.edu
Summary
Rigid fixation offers superior stability for mandibular advancement surgery compared to wire fixation, significantly reducing relapse over two years. This finding is crucial for long-term skeletal stability after osteotomy.
Area of Science:
- Orthognathic surgery
- Craniofacial reconstruction
- Skeletal stability
Background:
- Mandibular advancement surgery is used to correct skeletal discrepancies.
- Maintaining skeletal stability post-surgery is critical for treatment outcomes.
- Different fixation methods, rigid and wire, are employed.
Purpose of the Study:
- To compare the long-term skeletal stability of rigid fixation versus wire fixation after mandibular advancement surgery.
- To assess the degree of relapse at up to two years postoperatively.
Main Methods:
- A multisite, prospective clinical trial involving 127 patients undergoing mandibular advancement surgery.
- Patients were randomized to receive either rigid fixation (n=78) or wire fixation (n=49).
- Cephalometric radiographs were taken at multiple time points up to two years post-surgery to measure skeletal changes.
Main Results:
- Both fixation groups achieved similar sagittal and vertical advancements.
- The wire fixation group experienced 30% sagittal relapse of the mandibular symphysis after two years.
- The rigid fixation group showed no significant sagittal relapse (P < .001).
Conclusions:
- Rigid fixation provides significantly greater skeletal stability for mandibular advancement compared to wire fixation.
- Rigid fixation is the preferred method for maintaining mandibular position after sagittal split ramus osteotomy.
- Long-term stability is enhanced with rigid fixation techniques.