title: Skeletal stability in orthognathic surgery: evaluation of methods of rigid internal fixation after counterclockwise rotation in patients with class II deformities.
abstract: Our aim was to assess the influence of internal fixation in skeletal stability on patients who had had counterclockwise rotation of the maxillomandibular complex and mandibular advancement procedures. We studied 60 records of 20 patients (14 female, 6 male), mean (range) age at operation 29 (16-50) years. The mean (range) postoperative follow-up was 15 (8-24) months. Sixty standard lateral cephalometric radiographs were randomly traced and digitised by one senior radiologist to estimate surgical and postoperative changes. Patients were divided into two groups, the first group (n=10) of which had fixation with only 2.0 system plates (2 plates with monocortical screws alone) and the second (n=10) of which had hybrid fixation (1 plate with monocortical screws and 2 or 3 bicortical bone screws). During operation the change in the mean occlusal plane with counterclockwise rotation was 9.4° (range -17.3 to -2.5mm). The maxilla moved forward and upward. All the anterior mandibular measurements had advanced horizontally, the mean (range) being 17 (6.4 to 9.9) mm for the pogonion, and 17.6 (6.0 to 30.7) mm for the menton. At the longest follow-up period, there were significant long-term changes, but these were clinically acceptable (<2mm). There was no significant difference between the two groups in postoperative stability or in the magnitude of the advancement and stability.
authors.affiliation: Postgraduate Program in Dentistry, Dental School, Federal University of Uberlândia, Uberlândia, MG, Brazil. Electronic address: vacastro@uol.com.br.
authors.forename: Vanessa Álvares de Castro
authors.initials: VÁ
authors.lastname: Rocha
authors.affiliation: Department of Oral and Maxillofacial Surgery, Santa Izabel Hospital, Salvador, BA, Brazil.
authors.forename: Antonio Irineu Trindade
authors.initials: AI
authors.lastname: Neto
authors.affiliation: Dental School, Federal University of Bahia, Salvador, BA, Brazil.
authors.forename: Iêda Margarida Crusoé Rocha
authors.initials: IM
authors.lastname: Rebello
authors.affiliation: Department of Oral and Maxillofacial Surgery, Santa Izabel Hospital, Salvador, BA, Brazil.
authors.forename: Gustavo Mota Mascarenhas
authors.initials: GM
authors.lastname: de Souza
authors.affiliation: Department of Oral and Maxillofacial Surgery, Santa Izabel Hospital, Postgraduate Program in Dentistry, Dental School, Federal, University of Bahia, Salvador, BA, Brazil.
authors.forename: Lucas Senhorinho
authors.initials: LS
authors.lastname: Esteves
authors.affiliation: Postgraduate Program in Human Pathology and Dentistry, Dental School, Federal University of Bahia, Salvador, BA, Brazil.
authors.forename: Jean Nunes
authors.initials: JN
authors.lastname: dos Santos
authors.affiliation: Postgraduate Program in Dentistry, Dental School, Federal University of Uberlândia, Uberlândia, MG, Brazil.
authors.forename: Darceny
authors.initials: D
authors.lastname: Zanetta-Barbosa
authors.affiliation: Postgraduate Program in Dentistry, Dental School, Federal University of Uberlândia, Uberlândia, MG, Brazil.
authors.forename: Célio Jesus
authors.initials: CJ
authors.lastname: do Prado
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates / Q000706:statistics & numerical data*; D002508:Cephalometry; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging* / Q000601:surgery; D019186:Mandibular Advancement; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D012399:Rotation; D055815:Young Adult
keywords: Bone fixation; Occlusal plane; Orthognathic surgery; Stability