Angled Screws With Locking Plates-An Alternative Fixation for Minimally Invasive Mandibular Orthognathic Surgery

The purpose of this study was to evaluate the short-term behavior of angled screws with locking plates after bilateral sagittal split osteotomy using the anterior oblique technique within the concept of minimally invasive orthognathic surgery (MIOS).

Twenty patients who underwent bimaxillary surgery with mandibular advancement were included in this preliminary and retrospective study. All patients underwent computed tomography preoperatively and 1 day postoperatively. The incidence of neurosensory dysfunction, clinical evaluation of the occlusion and temporomandibular joint, and overall complications were recorded during a minimum follow-up of 4 months.

The mean extent of sagittal mandibular advancement movements was 7.2 mm (2.5-13.2 mm). All patients had stable occlusion without evidence of temporomandibular joint dysfunction. None of the patients presented with dysaesthesia, hyperaesthesia, or anesthesia after four months of follow-up.

The overall results of this study are very satisfactory with no major or minor complications. The new design of mandibular plates with locking screws can be an alternative in all orthognathic surgeries, but especially interesting for minimally invasive approaches where stronger fixation is needed. Long-term studies are needed to draw further conclusions.