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Mandibular sagittal split osteotomy: is a bicortical 2-screw osteosynthesis adequate?
Max Hugentobler1, Vincent Lenoir, Paolo Scolozzi
1Division of Maxillofacial and Oral Surgery, Department of Surgery, Faculty of Medicine, University Hospital, Geneva, Switzerland.
The Journal of Craniofacial Surgery
|November 10, 2011
Summary
This study shows that the Hunsuck/Epker–type mandibular split osteotomy with two screws is a successful treatment for dentofacial deformities, with a low rate of major complications and high success.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Surgical Innovation
Background:
- Mandibular dentofacial deformities require effective surgical correction.
- Traditional methods often involve maxillomandibular fixation, which can impact patient comfort and recovery.
- The Hunsuck/Epker–type mandibular split osteotomy offers an alternative surgical approach.
Purpose of the Study:
- To prospectively evaluate the accuracy and reliability of the Hunsuck/Epker–type mandibular split osteotomy.
- To assess the efficacy of using two bicortical positioning screws without postoperative maxillomandibular fixation.
- To determine the complication rates and success outcomes in treating mandibular dentofacial deformities.
Main Methods:
- Prospective analysis of clinical and radiologic data from 54 patients.
- Evaluation of Hunsuck/Epker–type mandibular split osteotomy with two bicortical screws.
- Recording of patient age, sex, healing status, and complications (minor and major).
Main Results:
- A high success rate of 94.5% was observed in 51 patients.
- Minor complications occurred in 24% of patients, requiring no surgical intervention.
- Major complications, such as screw loosening, occurred in 5.5% of patients, necessitating hardware removal and reosteosynthesis.
Conclusions:
- The Hunsuck/Epker–type mandibular split osteotomy with two bicortical screws is a reliable and accurate technique.
- This method achieves a high success rate in treating mandibular dentofacial deformities.
- The adjunctive use of postoperative maxillomandibular fixation can be avoided, reducing patient morbidity.
