Technical factors accounting for stability of a bilateral sagittal split osteotomy advancement: wire osteosynthesis versus rigid fixation.
OBJECTIVE
Relapse after bilateral sagittal split osteotomy has been attributed to various technical factors that are inherent in the surgical procedure. The purpose of this article was to analyze technical factors that predispose to relapse when wire or rigid fixation is used.


METHODS
Patients were randomized to either rigid or wire osteosynthesis. Cephalometric radiographs were obtained and digitized at multiple time periods before and after surgery. Data were analyzed through use of 2-sample t tests and stepwise regression analyses.


RESULTS
Multivariate analysis indicated that the following factors correlated with relapse: initial advancement, change in ramus in inclination, change in the mandibular plane, and fixation type.


CONCLUSIONS
Relapse increased with the amount of initial advancement and, to a lesser extent, with control of the proximal segment and change in the mandibular plane. These factors are similar for wire osteosynthesis and rigid fixation.
Van Sickels
J E
JE
Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, Lexington 40536-0297, USA.
Dolce
C
C
Keeling
S
S
Tiner
B D
BD
Clark
G M
GM
Rugh
J D
JD
D000293:Adolescent; D001864:Bone Wires / Q000009:adverse effects* / Q000706:statistics & numerical data; D002508:Cephalometry; D005500:Follow-Up Studies; D006801:Humans; D019248:Jaw Fixation Techniques / Q000009:adverse effects* / Q000706:statistics & numerical data; D008312:Malocclusion, Angle Class II / Q000000981:diagnostic imaging / Q000601:surgery; D019186:Mandibular Advancement / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence