Are there risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy?

Abstract

PURPOSE:

Bone defects of the inferior mandibular border (osseous inferior border defects) can cause unesthetic postoperative outcomes after bilateral sagittal split osteotomy (BSSO). The aim of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify risk factors for this complication.

MATERIALS AND METHODS:

This retrospective study included consecutive patients who underwent BSSO for mandibular retrognathia. The primary outcome was the presence/absence of osseous inferior border defects. Predictors included the mandibular movement, rotation of the occlusal plane, postoperative proximal segment position, pattern of lingual fracture, occurrence of bad split, and presence of third molars.

RESULTS:

The study sample consisted of 200 patients and had a mean follow-up of 13 months. The mean mandibular advancement and rotation was respectively 5.8 mm and 5.4° clockwise. Osseous inferior border defects were present in 7.0% of splits and in 12.5% of patients. Significant risk factors for inferior border defects included increased advancement, increased clockwise rotation, cranial rotation of the proximal segment, and a split originating in the lingual cortex.

CONCLUSION:

In conclusion, osseous inferior border defects occur significantly more often in cases with large mandibular advancement, increased clockwise rotation of the occlusal plane, malpositioning of the proximal segment, and a split originating in the lingual cortex.

• Authors: J P Verweij, J G van Rijssel, M Fiocco, G Mensink, P J J Gooris, J P R van Merkesteyn
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 45 Issue 2 Pg. 192-197 (Feb 2017) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 28065728 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Adult
• Dental Occlusion
• Female
• Humans
• Male
• Mandible (diagnostic imaging, pathology, surgery)
• Middle Aged
• Molar, Third (pathology)
• Osteotomy, Sagittal Split Ramus (adverse effects)
• Radiography, Panoramic
• Retrognathia (diagnostic imaging, surgery)
• Retrospective Studies
• Risk Factors
• Young Adult