Vertical Ramus Osteotomy, Is It Still a Valid Tool in Orthognathic Surgery?

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Surgical Outcomes

Background:

• Mandibular osteotomies are crucial in orthognathic surgery to correct jaw deformities.
• Intraoral vertical ramus osteotomy (IVRO) and sagittal split osteotomy (SSO) are the primary surgical techniques.
• Evaluating complication rates and surgical efficiency is essential for optimizing patient care.

Purpose of the Study:

• To compare the complication rates and surgical outcomes of IVRO and SSO in orthognathic surgery.
• To assess differences in hospitalization duration, surgical time, and follow-up periods between IVRO and SSO.
• To identify the safety and efficacy profiles of these two mandibular osteotomy procedures.

Main Methods:

• Retrospective cohort study of 144 patients undergoing orthognathic surgery between 2010-2019.
• Analysis of records for patients who had either IVRO or SSO procedures.
• Comparison of postoperative complications, hospitalization duration, and surgical times.

Main Results:

• IVRO procedures were associated with shorter hospitalization compared to SSO overall.
• Bimaxillary IVRO procedures demonstrated significantly shorter surgical durations than bimaxillary SSO.
• The IVRO group experienced significantly fewer postoperative complications, including skeletal relapse, TMJ dysfunction, sensory impairment, and infection.

Conclusions:

• Both IVRO and SSO exhibit acceptable complication rates in orthognathic surgery.
• IVRO presents as a safer and simpler option with a lower complication profile.
• Patient compliance may be a consideration favoring SSO in certain clinical scenarios.