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Minimizing Relapse in Mandibular Asymmetry Correction by BSSRO with Intentional Osteotomy of Distal Segment: A
R Vimalraj1, N Jayakumar1, K George Varghese1
1Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala 686008 India.
Introduction:
Surgical correction of the patients with mandibular asymmetry by bilateral sagittal split ramus osteotomy (BSSRO) creats remarkable results in the immediate post operative period, but it carries a high risk of relapse by powerful muscle forces and the osteotomized segments. To minimize this risk, literatures highlight the procedure of an intentional osteotomy and stripping of muscles. A prospective study was conducted in Government Dental College, Kottayam, Kerala, to assess the effect of intentional osteotomy of posterior part of distal segment and stripping of medial pterygoid muscle on the proximal segment on affected side in mandibular asymmetry patients treated with BSSRO.
Materials And Methods:
20 patients above 18 years with mandibular asymmetry underwent surgical correction by BSSRO setback and rotation. Clinical evaluation and postero anterior cephalogram (PA Ceph) were used to assess relapse. PA cephalogram taken post operatively at 2 weeks, 6 months and 1year were compared using cephalometric parameters by Grummons analysis to assess relapse. Paired t test and Chi-square test was used to analyse quantitative and qualitative parameters respectively with statistical significance of p < 0.05.
Results:
Barring Methodological errors which is inevitable, the amount of relapse was not statistically significant with respect to dental midline, chin midline and frontal photograph.
Conclusion:
Intentional osteotomy of posterior part of distal segment and stripping of medial pterygoid muscle on the affected side can prevent relapse in patients who underwent surgical correction of mandibular asymmetry by BSSRO set back and rotation.
