A comparison between superior and inferior border wiring techniques in sagittal split ramus osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Surgical Anatomy

Background:

• Maintaining proper segment alignment after sagittal split ramus osteotomy (SSRO) is critical for surgical success.
• Variations in fixation techniques can influence postoperative segment positioning and stability.

Purpose of the Study:

• To compare the efficacy of superior border wiring versus inferior border wiring in stabilizing segments after mandibular advancement via SSRO.
• To evaluate the impact of each wiring technique on key cephalometric parameters related to segment rotation and angulation.

Main Methods:

• A retrospective study of 35 patients undergoing SSRO with advancement.
• Preoperative and postoperative lateral cephalograms were analyzed for 19 patients with inferior border wiring and 16 with superior border wiring.
• Cephalometric analysis focused on anterosuperior rotation of the proximal segment, gonial angle changes, and condylar sag.

Main Results:

• The inferior border wiring technique demonstrated a statistically significant reduction in anterosuperior rotation of the proximal segment compared to the superior border wiring technique.
• A significantly smaller increase in the gonial angle was observed with the inferior border wiring method.
• These findings indicate less displacement of the proximal segment with inferior border wiring during SSRO advancement.

Conclusions:

• Inferior border wiring is a more effective technique for minimizing undesirable proximal segment rotation and gonial angle increase following SSRO.
• The inferior border wiring technique offers superior stability and predictable outcomes in mandibular advancement surgeries.