Interferences between mandibular proximal and distal segments in orthognathic surgery for patients with asymmetric mandibular prognathism depending on different osteotomy techniques.
OBJECTIVE
The aim of this study was to evaluate, using computer simulation, the amount of interference between the proximal and distal segments of the mandible incurred by 3 different osteotomy methods.


METHODS
With the 3-dimensional facial computerized tomography data of 20 patients showing mandibular prognathism with asymmetry, simulation surgeries of conventional sagittal split ramus osteotomy (SSRO), intraoral vertical ramus osteotomy (IVRO), or short lingual osteotomy (SLO) was performed. The distal segments were moved backward (3, 6, or 9 mm) and rotated (2 degrees, 4 degrees, or 6 degrees). The amounts of interference between the proximal and distal segments of the mandible were measured and statistically analyzed.


RESULTS
Conventional SSRO demonstrated the greatest interference between the proximal and distal segments of the mandibles (P < .01), followed by IVRO and SLO. SLO showed less interference than IVRO in mild asymmetry cases (P < .05), but no difference was noted in severe prognathism and asymmetry cases.


CONCLUSIONS
SLO is the most favorable osteotomy method for reducing displacement of the proximal segment in mandibular prognathism with asymmetry.
Yang
Hoon Joo
HJ
Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
Lee
Woo Jin
WJ
Yi
Won Jin
WJ
Hwang
Soon Jung
SJ
D002508:Cephalometry / Q000379:methods; D003198:Computer Simulation; D003724:Dental Arch / Q000473:pathology / Q000601:surgery; D005146:Facial Asymmetry / Q000601:surgery*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008335:Mandibular Condyle / Q000473:pathology; D008953:Models, Anatomic; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010027:Osteotomy / Q000145:classification / Q000379:methods*; D010347:Patient Care Planning; D011378:Prognathism / Q000601:surgery*; D012399:Rotation; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface