Functional and radiographic long-term results after bad split in orthognathic surgery.
Bilateral sagittal split osteotomy (BSSO) is a standard procedure in orthognathic surgery. The aim of the present study was to perform a matched pair analysis (bad sagittal split versus regular sagittal split) regarding the functional and radiographic long-term results after BSSO. Of 110 cases of mandibular hypoplasy treated with BSSO, 7 cases of bad sagittal splits (Group A) were selected, clinically examined and matched to 7 cases where no bad split occurred (Group B). The Research Diagnostic Criteria for Temporo Mandibular Disorders (RDC/TMD), condylar morphology scale (CMS) and ramus height measurements using orthopantomograms were carried out in the follow-up period to observe the clinical and functional status and condylar resorbtion or remodelling. The mean follow-up time was 28.6 months. The RDC/TMD examination did not show a higher incidence of temporomandibular dysfunction, including pain or clicking in the bad split group. Patients without a bad split showed statistically significant (p<0.05) better mouth opening. The CMS measurements were comparable in both groups. When compared with regular splits, bad splits, if treated in an appropriate manner, have a good chance of functional success, although, some mandibular movements can be compromised.
Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University Halle-Wittenberg, Germany. rafaelblockveras@gmail.com
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Veras
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Kriwalsky
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Hoffmann
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Maurer
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Schubert
D000328:Adult; D000367:Age Factors; D016723:Bone Remodeling / Q000502:physiology; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D002508:Cephalometry; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000503:physiopathology; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology; D016896:Treatment Outcome