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A Mouse Distraction Osteogenesis Model
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[Mandibular advancement: bilateral sagittal split versus -distraction osteogenesis].

V Akkerman, J P Ho, E M Baas

    Nederlands Tijdschrift Voor Tandheelkunde
    |November 17, 2015
    PubMed
    Summary

    Bilateral sagittal split osteotomy (BSSO) is as effective as distraction osteogenesis (DO) for mandibular advancement, offering comparable stability and nerve outcomes with less pain and cost.

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    Area of Science:

    • Oral and Maxillofacial Surgery
    • Orthognathic Surgery
    • Surgical Innovation

    Context:

    • The introduction of intra-oral distraction osteogenesis (DO) in the 1990s offered a potential alternative to traditional bilateral sagittal split osteotomy (BSSO) for mandibular advancement.
    • Initial assumptions suggested DO provided superior stability and reduced neurosensory disturbances compared to BSSO.
    • A lack of robust scientific evidence supported these initial claims.

    Purpose:

    • To compare the efficacy, stability, and patient outcomes of distraction osteogenesis (DO) versus bilateral sagittal split osteotomy (BSSO) for mandibular advancement.
    • To evaluate neurosensory disturbances of the inferior alveolar nerve associated with both procedures.
    • To assess patient-reported pain and overall treatment costs.

    Summary:

    • Recent prospective studies indicate that BSSO is not inferior to DO regarding treatment stability and inferior alveolar nerve neurosensory disturbances.
    • BSSO procedures result in significantly less patient pain and lower overall treatment costs compared to DO.
    • Mandibular advancement up to 10 mm in non-syndromal patients demonstrates BSSO as a viable and potentially superior standard therapy.

    Impact:

    • Challenges the long-held assumptions about the superiority of distraction osteogenesis for mandibular advancement.
    • Provides evidence-based recommendations for surgical planning in orthognathic surgery.
    • Highlights the cost-effectiveness and patient comfort benefits of bilateral sagittal split osteotomy, influencing clinical practice guidelines.