A follow-up of osteotomies for dysgnathia

An invitation to report for a follow-up was accepted by 74 patients (51 females and 23 males) who had undergone various types of osteotomy (50 mandibular and 30 maxillary osteotomies; 6 patients had undergone both mandibular and maxillary osteotomy). Their age at the time of operation ranged from 15 to 44 years. The follow-up period ranged from 3 months to 7 years. Maxillary osteotomy was never followed by a relapse, but 12 of the 50 patients treated by mandibular osteotomy showed some relapse: hyperplasia of the mandibular condylar process caused some relapse in 2 cases, and in 10 other cases only partial relapse (1, 2 or 3 mm) occurred. The distribution over the various types of operation corresponded with the various methods used in the entire series, so that no particular type of operation had evident advantages or disadvantages. It is essential that stable occlusion is achieved during the operation. Osteosynthesis of the fracture fragments proved unnecessary after a sagittal split operation. No indications that an oversize tongue played a role were found. The results with regard to the temporomandibular joint were particularly favorable. Stable occlusion is essential in preventing relapse; this is one of the reasons why a careful long-term follow-up is indicated (at 2-year intervals). For the time being this is perhaps best carried out by the operating surgeon, who has previous models and knows the patient.