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Radiographic stereophotogrammetric evaluation of intersegmental stability after mandibular sagittal split osteotomy
1Department of Oral and Maxillofacial Surgery, Helsingborg Hospital, Helsingborg, Sweden. gert.wall@helsingborgslasarett.se
Summary
Rigid fixation methods using bicortical screws or miniplates do not fully prevent bone mobility after mandibular sagittal split osteotomies. This mobility can persist for up to one year post-surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Biomechanical Analysis
Background:
- Bilateral mandibular sagittal split osteotomy is a common procedure in orthognathic surgery.
- Achieving stable fixation is crucial for successful outcomes and minimizing complications.
Purpose of the Study:
- To evaluate the efficacy of rigid fixation techniques in preventing osteotomy site mobility.
- To determine if bicortical screws and/or miniplates with monocortical screws provide absolute stability.
Main Methods:
- Radiographic stereophotogrammetry was used to measure bone segment displacement in 10 patients.
- Three metal bone markers were placed in proximal and distal segments.
- Measurements were taken at rest and under stress during the first postoperative year.
Main Results:
- Immediate postoperative mobility was observed in 80% of patients (8/10).
- Mobility persisted in 40% of patients (4/10) at the 1-year follow-up.
- Displacement exceeding 0.4 degrees and 0.2 mm indicated true bone segment movement.
Conclusions:
- Current rigid fixation methods do not completely eliminate mobility at the osteotomy site.
- Mobility can be a long-term finding, persisting up to one year post-surgery.
- The term 'rigid fixation' may be inaccurate for these techniques.