Single-splint technique in orthognathic surgery: intraoperative checkpoints to control facial symmetry.
BACKGROUND
Despite the most meticulous preoperative planning and execution, intraoperative soft-tissue response to dentoskeletal changes is often different from those statistically predicted, especially when midline asymmetry is present. A "single-splint" technique for bimaxillary surgery, with intraoperative adjustments and checkpoints, was developed in an attempt to overcome these limitations. The purpose of this study was therefore to determine whether this technique can improve the midline symmetry of facial soft tissues.


METHODS
Forty-five patients who underwent at least a Le Fort I and a bilateral sagittal split osteotomy of the mandible were identified in the authors' patient database. Standardized frontal photographs were used to measure the change in midfacial, intercommissural, chin to midface, and chin to ideal facial midline angles. The facial midline symmetry index, an overall score of facial symmetry, was also calculated.


RESULTS
This study demonstrates that there is a statistically significant improvement of the four angles measured and of the facial midline symmetry index.


CONCLUSIONS
These findings demonstrate that the single-splint technique with its intraoperative checkpoints can successfully maintain or improve facial midline symmetry. Thus, the single-splint technique is a useful alternative to the classic two-splint technique for bimaxillary surgery.
Yu
Chung-Chih
CC
Taipei, Taiwan From the Craniofacial Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University.
Bergeron
Leonard
L
Lin
Cheng-Hui
CH
Chu
Yong-Ming
YM
Chen
Yu-Ray
YR
D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D017090:Occlusal Splints; D019340:Osteotomy, Le Fort / Q000379:methods*; D011378:Prognathism / Q000473:pathology / Q000601:surgery*; D055815:Young Adult