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Three-dimensional evaluation of mandibular width after mandibular asymmetric setback surgery using sagittal split

Seong-Sik Kim1, Sung-Hun Kim1, Yong-Il Kim1

  • 1Department of Orthodontics, Dental Research Institute, and Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Korea.

Korean Journal of Orthodontics
|March 24, 2023
PubMed
Summary

Sagittal split ramus osteotomy (SSRO) temporarily widens the mandible, but width returns to baseline six months post-surgery for both symmetric and asymmetric cases. This finding is crucial for understanding mandibular setback surgery outcomes.

Keywords:
Class III orthognathic surgeryComputed tomographyFacial asymmetry

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • 3D Imaging in Dentistry

Background:

  • Mandibular prognathism, particularly asymmetric cases, often requires surgical correction.
  • Sagittal split ramus osteotomy (SSRO) is a common procedure for mandibular setback.
  • Understanding the dimensional changes of the mandible post-SSRO is critical for surgical planning and outcome assessment.

Purpose of the Study:

  • To evaluate changes in mandibular width following SSRO in patients with mandibular asymmetric prognathism.
  • To compare the effects of SSRO on mandibular width in symmetric versus asymmetric setback groups.
  • To assess the stability of mandibular width changes at different postoperative time points.

Main Methods:

  • Seventy patients undergoing SSRO for mandibular setback were divided into symmetric (n=35) and asymmetric (n=35) groups.
  • Cone-beam computed tomography (CBCT) was used to measure mandibular width at three time points: pre-surgery (T1), 3 days post-surgery (T2), and 6 months post-surgery (T3).
  • Repeated measures ANOVA was employed for statistical analysis of mandibular width variations.

Main Results:

  • Both symmetric and asymmetric groups exhibited a significant increase in mandibular width at T2 (immediate post-op).
  • A significant decrease in mandibular width was observed by T3 (6 months post-op), returning to T1 levels.
  • No statistically significant differences in mandibular width changes were found between the symmetric and asymmetric groups at any time point.

Conclusions:

  • Mandibular width increases transiently after SSRO for setback surgery.
  • Mandibular width demonstrates stability, returning to preoperative dimensions by six months post-SSRO.
  • SSRO outcomes regarding mandibular width are comparable between symmetric and asymmetric mandibular setback procedures.