Bilateral sagittal split osteotomies versus mandibular distraction osteogenesis: a prospective clinical trial comparing inferior alveolar nerve function and complications.
The aim of this study was to conduct a prospective clinical trial comparing the neurosensory function of the inferior alveolar nerve (IAN) after mandibular advancement surgery with either bilateral sagittal split osteotomies (BSSO) or mandibular distraction ostoegenesis (MDO). 23 Class II mandibular hypoplasia patients requiring mandibular advancement were randomized into two groups for either BSSO or MDO. Subjective and objective neurosensory evaluations were performed preoperatively and at the following postoperative times: 2 weeks (TBD1), 6 weeks (TBD2), 12 weeks (TBD3), 6 months (TBD4) and 12 months (TBD5). Subjective evaluation included the use of a visual analogue scale (VAS). Objective evaluation included the use of light touch (LT), two-point discrimination (2PD) and pain detection threshold (PD) tests. Intra-operative or postoperative complications were recorded. Using a mixed model, no significant differences were reported in subjective VAS scores and objective LT, 2PD and PD scores between the BSSO and MDO groups over 12 months (p>0.05). Common postoperative complications included localized wound infection (BSSO=2, MDO=6) and condylar resorption (BSSO=1, MDO=1).
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Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR.
Cheung
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D000293:Adolescent; D000328:Adult; D020209:Cranial Nerve Injuries / Q000209:etiology* / Q000517:prevention & control; D004192:Discrimination, Psychological / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000294:innervation / Q000601:surgery; D019186:Mandibular Advancement / Q000009:adverse effects / Q000379:methods*; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D017288:Pain Threshold / Q000502:physiology; D011446:Prospective Studies; D063173:Retrognathia / Q000601:surgery*; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome; D061221:Trigeminal Nerve Injuries; D055815:Young Adult