Does Fixation Method Affect Stability of Sagittal Split Osteotomy and Condylar Position?

Publication date: Available online 31 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Reza Tabrizi, Fereydoun Pourdanesh, Hassan Mirmohammad Sadeghi, Sholeh Shahidi, Behnaz Poorian
PurposeFixation methods are important for condylar position and stability in sagittal split osteotomy (SSO) procedures. The aim of this study was to compare changes of the condylar position and stability following SSOs for mandibular setback in plate fixation with monocortical screw and bicortical screws.Materials and MethodsIn this retrospective cohort study, patients who underwent mandibular setback were studied in two groups. In group 1, fixation was done via miniplate with four monocortical screws and in group 2, this was done via 3 bicortical screws. Cone beam computed tomography (CBCT) scans were taken before and immediately after SSOs and one year later. Condylar position was evaluated linearly (mediolateral movement in the coronal view) and angularly (condylar axis with Frankfort plane in the coronal view). Stability of the mandible was determined at the B point horizontally and vertically.ResultsForty-eight patients were studied in two equal groups. A significant difference for the mediolateral changes of the condyle before and after osteotomies was detected between the two groups (P=0.003). There was no difference between the two groups for angular changes of the condyle before and after SSOs in the coronal view (P=0.45). Analysis of the data did not reveal any differences for vertical relapse at the B point (P=0.47) or horizontal relapse between the two groups (P=0.21).ConclusionAccording to this study, bicortical screw fixation may be associated with more condylar displacement. However, we could not find significant differences in surgical stability between miniplate fixation with monocortical screws or bicortical screw fixation after one year of follow-up.



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