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Is a Final Splint Necessary in Bimaxillary Orthognathic Surgery?
Jeffrey C Posnick1,2,3,4, Brian E Kinard1,5
1Formerly Posnick Center for Facial Plastic Surgery, Chevy Chase, MD.
The Journal of Craniofacial Surgery
|May 21, 2020
Summary
In bimaxillary orthognathic surgery, a final occlusal splint is infrequently used and rarely maintained post-surgery. This study suggests splints are often unnecessary for achieving planned occlusion during initial healing.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Dental Research
Background:
- Bimaxillary orthognathic surgery frequently utilizes occlusal splints to establish and maintain occlusion during initial skeletal healing.
- The necessity and effectiveness of these splints in routine practice warrant further investigation.
Purpose of the Study:
- To determine the frequency of final occlusal splint use for achieving planned intraoperative occlusion in bimaxillary orthognathic surgery.
- To assess the rate of splint retention post-surgery and its role in maintaining occlusion during the initial 5-week healing phase.
Main Methods:
- Retrospective case series design analyzing demographic and operative variables.
- Outcome variables included splint usage, reasons for retention, and comparison of achieved versus planned occlusion after 5 weeks.
- Descriptive statistics were employed to report findings.
Main Results:
- A final occlusal splint was used in 39% of cases to achieve occlusion and maintained postoperatively in only 10%.
- No transverse relapse occurred during the 5-week healing period without splint maintenance.
- Planned open-bite cases (n=8) showed vertical improvement or closure without splint retention.
Conclusions:
- Routine use and postoperative maintenance of final occlusal splints are not essential for the majority of bimaxillary orthognathic surgery cases.
- The findings suggest that planned occlusion can often be achieved and maintained without prolonged splint use, even in cases with planned open-bites.
