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Correlation between intraoperative proximal segment rotation and post-sagittal split ramus osteotomy relapse: a
B-J Choi1, B-S Lee1, Y-D Kwon1
1Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea.
International Journal of Oral and Maxillofacial Surgery
|November 18, 2017
Summary
The extent of mandibular setback correlates with relapse after sagittal split ramus osteotomy (SSRO). However, proximal bone segment rotation does not significantly impact long-term postoperative relapse in skeletal class III malocclusion patients.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- 3D Imaging and Analysis
- Skeletal Malocclusion Correction
Background:
- Skeletal class III malocclusion often requires surgical correction.
- Sagittal split ramus osteotomy (SSRO) is a common procedure for mandibular advancement or setback.
- Understanding factors influencing postoperative relapse is crucial for treatment success.
Purpose of the Study:
- To investigate the influence of proximal segment rotation and mandibular setback extent on relapse after SSRO.
- To analyze the three-dimensional (3D) behavior of proximal bone segments post-SSRO.
- To identify predictors of postoperative relapse in patients with skeletal class III malocclusion.
Main Methods:
- Utilized 3D analysis of cone beam computed tomography (CBCT) scans from 31 skeletal class III patients.
- Assessed mandibular condyle movements at multiple time points: pre-operation, 1 week, 6 months, and 1 year post-operation.
- Correlated proximal segment rotation and mandibular setback magnitude with relapse rates.
Main Results:
- Proximal segments exhibited increased yaw and roll immediately post-SSRO, but reverted to original positions by 6 months to 1 year.
- A positive correlation was found between the extent of mandibular setback and relapse at 6 months and 1 year.
- Proximal bone segment rotation during surgery showed no significant relationship with postoperative relapse.
Conclusions:
- The degree of mandibular setback is a significant factor in SSRO relapse.
- While initial displacement of proximal segments occurs, they tend to stabilize over time.
- Proximal segment rotation is not a primary driver of relapse following SSRO in this patient cohort.
