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Changes in mandibular angle and intergonial width after bilateral sagittal split ramus osteotomy or bimaxillary
D Bi1, H Gao1, M Q H Al-Watary1
1State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
International Journal of Oral and Maxillofacial Surgery
|October 27, 2024
Summary
Orthognathic surgery can alter mandibular morphology. Minimizing proximal segment displacement and rotation is crucial for preserving the mandibular angle and width post-surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- 3D Imaging in Medicine
Background:
- Class II deformities often require orthognathic surgery.
- Mandibular angle changes post-surgery impact facial aesthetics.
- Understanding morphological changes is key for surgical planning.
Purpose of the Study:
- Evaluate morphological changes in the mandibular angle area after orthognathic surgery.
- Investigate factors associated with these changes, including mandibular rotation.
- Compare outcomes between different surgical techniques.
Main Methods:
- Retrospective study of 58 Class II deformity patients.
- Analysis of computed tomography (CT) scans at pre-op, 1-month, and 6-month post-op.
- Comparison of three groups: bilateral sagittal split ramus osteotomy, bimaxillary surgery with counterclockwise rotation, and bimaxillary surgery without rotation.
Main Results:
- Intergonial width significantly increased in all surgical groups.
- Mandibular angle increased significantly after bilateral sagittal split ramus osteotomy and bimaxillary surgery without rotation.
- No significant mandibular angle increase was observed after bimaxillary surgery with counterclockwise rotation.
- Increased intergonial width correlated positively with lateral proximal segment displacement.
Conclusions:
- Surgical technique significantly influences mandibular angle changes.
- Counterclockwise rotation of the proximal segment may reduce mandibular angle increase.
- Minimizing displacement and rotation of proximal segments is vital for preserving mandibular angle morphology.
