title: Hybrid fixation in the bilateral sagittal split osteotomy for lower jaw advancement.
abstract: Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.
authors.affiliation: Brazilian Army, Juiz de Fora General Hospital, Juiz de Fora, MG, Brazil. fladeirapereira@yahoo.com.br
authors.forename: Felipe Ladeira
authors.initials: FL
authors.lastname: Pereira
authors.forename: Marcos
authors.initials: M
authors.lastname: Janson
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sant'Ana
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods*; D008340:Mandibular Nerve / Q000503:physiopathology; D008437:Maxilla / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort; D010292:Paresthesia / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D016896:Treatment Outcome