Predictability of bimaxillary orthognathic surgery using "piggyback" intermediate splints

Ten consecutive patients underwent bimaxillary surgery including segmental Le Fort I and bilateral sagittal split ramus osteotomies. All 10 patients were symmetric skeletal Class II malocclusion with an anterior open bite. Asymmetry cases were excluded. Dimensional changes depicted on the cephalometric prediction tracing were reproduced in the model surgery and then transferred to the patient during the operative procedure using a "piggyback" intermediate splint. All dimensional changes, except vertical, were transferred from the model surgery to the patient intraoperatively by using a "piggyback" intermediate splint. The accuracy of this transfer and final skeletal result was examined. All the data clearly showed that in no case was any discrepancy greater than 2 mm, which demonstrates the predictable results that can be achieved by using a "piggyback" intermediate splint in bimaxillary orthognathic surgery.