title: Does Intraoral Miniplate Fixation Have Good Postoperative Stability After Sagittal Splitting Ramus Osteotomy? Comparison With Intraoral Bicortical Screw Fixation.
abstract: OBJECTIVE
  Bicortical screw fixation systems and miniplate with monocortical screw fixation systems have been reported mainly in bilateral sagittal split ramus osteotomy (BSSO). This study compared postoperative stability between these 2 fixation systems by an intraoral approach.
  
  
  METHODS
  This was a retrospective cohort study. The study sample was composed of patients treated by BSSO at the authors' institute from January 2006 through December 2012. All cases had facial symmetry and were performed by setback surgery. The predictor variable was treatment group (intraoral screw fixation [SG] vs intraoral miniplate fixation [MG]), and the primary outcome variable was stability defined as the change in the position of point B. Other outcome variables were stability defined as the change in the position of the menton, blood loss, incidence of postoperative temporomandibular joint disorder, and nerve injury. Descriptive and bivariate statistics were computed and the P value was set at .05.
  
  
  RESULTS
  Seventy-five patients (35 men and 40 women; mean age, 25.8 yr) were divided into 2 groups (39 SG cases and 36 MG cases). Postoperative changes at point B and the menton in the 2 fixation groups were not statistically different. Lingual nerve injury occurred only in SG cases. Moreover, total blood loss was greater in SG cases.
  
  
  CONCLUSIONS
  An intraoral miniplate with monocortical screw fixation system is recommended over intraoral bicortical screw fixation for bone segments in setback BSSO in patients without facial asymmetry.
authors.affiliation: Research Fellow, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo; Assistant Professor, Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsushita
authors.affiliation: Assistant Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakakuki
authors.affiliation: Research Fellow, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Kosugi
authors.affiliation: Assistant Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Kurohara
authors.affiliation: Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: haradak.mfs@tmd.ac.jp.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Harada
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D001860:Bone Plates; D001863:Bone Screws; D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061222:Lingual Nerve Injuries / Q000209:etiology; D008297:Male; D008334:Mandible / Q000473:pathology; D008904:Miniaturization; D059229:Osteotomy, Sagittal Split Ramus / Q000295:instrumentation*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013705:Temporomandibular Joint Disorders / Q000209:etiology; D016896:Treatment Outcome; D061221:Trigeminal Nerve Injuries / Q000209:etiology; D055815:Young Adult