title: Stability of skeletal class III malocclusion after combined maxillary and mandibular procedures: rigid internal fixation versus wire osteosynthesis of the mandible.
abstract: OBJECTIVE
  The aim of this study was to evaluate skeletal stability after double-jaw surgery for correction of skeletal Class III malocclusion to assess whether there were any differences between wire and rigid fixation of the mandible.
  
  
  METHODS
  Thirty-seven Class III patients had Le Fort I osteotomy stabilized with plate and screws for maxillary advancement. Bilateral sagittal split osteotomy for mandibular setback was stabilized with wire osteosynthesis and maxillomandibular fixation for 6 weeks in 20 patients (group 1) and with rigid internal fixation in 17 patients (group 2). Lateral cephalograms were taken before surgery, immediately after surgery, 8 weeks after surgery, and 1 year after surgery.
  
  
  RESULTS
  Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. One year after surgery, maxillary sagittal stability was excellent in both groups, and bilateral sagittal split osteotomy accounted for most of the total horizontal relapse observed. In group 1, significant correlations were found between maxillary advancement and relapse at the posterior maxilla and between mandibular setback and postoperative counterclockwise rotation of the ramus and mandibular relapse. In group 2, significant correlations were found between mandibular setback and intraoperative clockwise rotation of the ramus and between mandibular setback and postoperative counterclockwise rotation of the ramus and mandibular relapse. No significant differences in postoperative skeletal and dental stability between groups were observed except for maxillary posterior vertical position.
  
  
  CONCLUSIONS
  Surgical correction of Class III malocclusion after combined maxillary and mandibular procedures appears to be a fairly stable procedure independent of the type of fixation used to stabilize the mandible.
authors.affiliation: Department of Maxillo-Facial Sirgery, Faculty of Medicine, Universisty of Udine, Udine, Italy. m.politi@med.uniud.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Politi
authors.forename: Fabio
authors.initials: F
authors.lastname: Costa
authors.forename: Roberto
authors.initials: R
authors.lastname: Cian
authors.forename: Francesco
authors.initials: F
authors.lastname: Polini
authors.forename: Massimo
authors.initials: M
authors.lastname: Robiony
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D002508:Cephalometry; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D019186:Mandibular Advancement / Q000295:instrumentation; D016555:Matched-Pair Analysis; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D017090:Occlusal Splints; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D014716:Vertical Dimension