Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 1 , Pages 50-59, January 2007

Transverse Displacement of the Proximal Segment After Bilateral Sagittal Split Osteotomy Advancement and Its Effect on Relapse

  • Anne D. Angle, DDS, MS

      Affiliations

    • Formerly, Orthodontic Resident, Mayo Clinic College of Medicine, Rochester, MN; and Currently, Private Practice, Royersford, PA.
  • ,
  • Joe Rebellato, DDS

      Affiliations

    • Formerly, Associate Professor of Orthodontics, Mayo Clinic College of Medicine, Rochester, MN; and Currently, Private Practice, Charlottesville, VA.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Rebellato: Department of Dental Specialties, Mayo Clinic, 200 First St SW, Rochester, MN 55905
  • ,
  • Rose D. Sheats, DDS, MPH

      Affiliations

    • Associate Professor, Department of Orthodontics, University of North Carolina, Chapel Hill, NC.

Purpose

To evaluate the transverse displacement of the proximal segment and its association with horizontal relapse post-treatment.

Methods

Retrospective study of 25 patients (10 males, 15 females) who underwent bilateral sagittal split osteotomy (BSSO) advancement and Le Fort I osteotomy with rigid internal fixation (RIF) using bicortical lag screws. Posteroanterior and lateral cephalograms obtained preoperatively (T1), early postoperatively (T2), and after orthodontic treatment completion (T3) were used to assess: the angulation of each proximal segment relative to the upper orbital margin line and obtain the sum of both angles (total angle), mandibular intergonial width (IGW), mandibular length (Ar-B), B point position, and condylion position. Paired t tests were used to determine statistically significant (P < .05) changes within the variables between various time points (T2-T1; T3-T2; T3-T1). Correlations between variables were estimated by calculating Pearson’s correlation coefficients.

Results

T2-T1 findings: all 25 patients showed an increase in IGW with a mean of 6.5 ± 2.5 mm and the angulations of the proximal segments increased 3.2 ± 2.6° (total angle change). Ar-B increased 3.8 ± 3.4 mm. B point moved anteriorly 4.8 ± 2.9 mm. T3-T2 findings: IGW decreased 1.8 ± 1.5 mm; angulation of the right and left proximal segments decreased 1.2 ± 2.8° (total angle change). Condylion moved superiorly 1.5 ± 2.0.

Conclusions

Statistically significant changes occurred in transverse width and angulation of proximal segments of patients who underwent BSSO advancement with Le Fort I osteotomy. No clinically significant associations were found between transverse displacement of the proximal segments and horizontal relapse.

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PII: S0278-2391(06)01357-7

doi:10.1016/j.joms.2005.11.117

Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 1 , Pages 50-59, January 2007