Relapse following bilateral sagittal split osteotomy with rigid internal fixation

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Skeletal Reconstruction

Background:

• This systematic review evaluates the relapse rates associated with mandibular advancement using bilateral sagittal split osteotomy (BSSO) with rigid internal fixation.
• The study synthesized data from 24 articles, including prospective and retrospective studies, to assess short-term and long-term outcomes.

Discussion:

• Relapse rates varied significantly depending on the type of rigid internal fixation used, with bicortical screws showing higher short-term and long-term relapse compared to miniplates.
• The deepest concavity on the anterior profile of the maxilla (point B) was used as the reference point for measuring relapse.
• The quality of included studies was generally low to medium, with none meeting high-quality criteria.

Key Insights:

• Short-term relapse ranged from 1.5% to 32.7% for bicortical screws and 1.5% to 18.0% for miniplates.
• Long-term relapse ranged from 2.0% to 50.3% for bicortical screws and 1.5% to 8.9% for miniplates.
• The study highlights the need for improved research methodologies to better understand BSSO outcomes.

Outlook:

• Future research should prioritize prospective study designs or randomized controlled trials (RCTs).
• Excluding concurrent surgical interventions like genioplasty or maxillary surgery is recommended for clearer BSSO outcome assessment.
• Incorporating correlation statistics in future studies will enhance the understanding of relapse determinants.