Mandibular sagittal split osteotomy: is a bicortical 2-screw osteosynthesis adequate?

The aim of this study was to prospectively evaluate the accuracy and reliability of the use of the Hunsuck/Epker–type mandibular split osteotomy together with osteosynthesis with placement of 2 bicortical positioning screws without the adjunctive use of a postoperative maxilla-mandibular fixation in the treatment of mandibular dentofacial deformities. We analyzed the clinical and radiologic data of 54 patients with dentofacial deformities. We recorded age and sex, status of healing, and complications. Postsurgical complications that were recorded as minor did not require surgical intervention, whereas major complications required further surgical intervention. Fifty-one patients (94.5%) had a successful treatment outcome without complications, 13 patients (24%) developed minor complications, and 3 patients (5.5%) developed screw loosening requiring hardware removal and reosteosynthesis. The present study has demonstrated that Hunsuck/Epker–type mandibular split osteotomy together with osteosynthesis with placement of 2 bicortical positioning screws without the adjunctive use of a postoperative maxilla-mandibular fixation in the treatment of mandibular dentofacial deformities results in a low rate of major complications with a high rate of success