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The need for intermaxillary fixation in sagittal split osteotomy setbacks with bicortical screw fixation
Byung-Ho Choi1, Shi-Jiang Zhu, Sang-Gueon Han
1Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University (Brain Korea 21 Project for Medical Science), Seoul, South Korea. choibh@wonju.yonsei.ac.kr
Summary
Bicortical screw fixation after mandibular setback surgery offers stability, potentially eliminating the need for intermaxillary fixation (IMF). This surgical approach ensures comparable outcomes to traditional methods, simplifying patient recovery.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Surgical Stability
Background:
- Intermaxillary fixation (IMF) is a traditional method used to stabilize the mandible post-surgery.
- Assessing alternative fixation methods is crucial for improving patient comfort and recovery.
- Bilateral sagittal split ramus osteotomies are common procedures for mandibular setback.
Purpose of the Study:
- To evaluate if bicortical screw fixation provides adequate stability to avoid intermaxillary fixation (IMF) after mandibular setback.
- To compare the stability of bicortical screw fixation versus miniplate fixation with IMF.
Main Methods:
- A retrospective study of 86 patients undergoing mandibular setback via bilateral sagittal split ramus osteotomies.
- Group 1: Miniplate fixation with 6 weeks of IMF (15 patients).
- Group 2: Bicortical screw fixation with immediate postoperative function (71 patients).
- Radiographic evaluation of pogonion changes at 24 months postoperatively.
Main Results:
- No significant difference in relapse magnitude was observed between the bicortical screw fixation group and the miniplate fixation with IMF group.
- Both fixation methods demonstrated comparable long-term stability over a 24-month follow-up period.
Conclusions:
- Bicortical screw fixation is a stable and effective method for mandibular setback surgery.
- This technique allows for the elimination of intermaxillary fixation (IMF), simplifying postoperative management and potentially improving patient function.