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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Long-term stability of surgical mandibular setback
1Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94115, USA. hcho@pacific.edu
The Angle Orthodontist
|August 10, 2007
Summary
Mandibular prognathism surgery using sagittal split osteotomy shows that initial bone segment movement during surgery predicts postsurgical relapse. Proximal segment repositioning during surgery influences the degree of mandibular rebound during orthodontic treatment.
Area of Science:
- Orthognathic surgery
- Craniofacial orthodontics
Background:
- Sagittal split osteotomy is a common surgical procedure for correcting mandibular prognathism.
- Understanding postsurgical skeletal stability is crucial for treatment outcomes.
Purpose of the Study:
- To investigate the correlation between proximal segment positional changes during surgery and mandibular rebound during postsurgical orthodontic treatment.
- To assess the predictability of postsurgical skeletal changes based on intraoperative repositioning.
Main Methods:
- Retrospective analysis of 34 patients undergoing sagittal split osteotomy for mandibular prognathism.
- Cephalometric radiographs at pre-surgery (T2), post-surgery (T3), and post-orthodontic treatment (T4).
- Measurement of linear and angular changes in the posterior border of the proximal segments and pogonion position.
Main Results:
- Significant linear correlation (r=.61) between proximal segment displacement during surgery and pogonion displacement during postsurgical orthodontic treatment.
- Strong angular correlation (r=.67) between proximal segment displacement during surgery and angular rebound of the proximal segments postsurgery.
- Demonstrated a predictable relationship between surgical repositioning and postsurgical skeletal changes.
Conclusions:
- The degree of proximal segment repositioning during sagittal split osteotomy surgery correlates with postsurgical mandibular rebound.
- Rigid fixation of altered proximal segment positions during mandibular surgery can lead to a tendency for segments to return toward their presurgical orientation.
- These findings highlight the importance of intraoperative positioning for long-term skeletal stability in orthognathic surgery.
