Skeletal Stability Following Bilateral Sagittal Split Osteotomy (BSSO) With and Without Condylar Positioning Device

Gerressen, Marcus; Stockbrink, Gereon; Smeets, Ralf; Riediger, Dieter; Ghassemi, Alireza

doi:10.1016/j.joms.2006.10.026

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 7 , Pages 1297-1302, July 2007

Skeletal Stability Following Bilateral Sagittal Split Osteotomy (BSSO) With and Without Condylar Positioning Device

Marcus Gerressen, MD, DMD, PhD
- Fellow, Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.
- Address correspondence and reprint requests to Dr Gerressen: Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie des Universitätsklinikums der RWTH Aachen, Pauwelsstraβe 30, 52074 Aachen, Germany
Gereon Stockbrink, MD, DMD, PhD
- Fellow, Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.
Ralf Smeets, MD, DMD, PhD
- Resident, Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.
Dieter Riediger, MD, DMD, PhD
- Professor and Chair, Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.
Alireza Ghassemi, MD, DMD, PhD
- Assistant Professor, Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.

Purpose

The goal of this retrospective study was to investigate whether utilization of condylar positioning devices in comparison to the manual positioning technique has a favorable influence on skeletal stability after bilateral sagittal split osteotomy.

Patients and Methods

Lateral cephalometric radiographs of 49 patients who had undergone bilateral sagittal split osteotomy or bimaxillary surgery at the Universitiy Hospital of Aachen between 1993 and 2003 were evaluated with the aid of analysis software (Adda Keph version 3.0, JR – datentechnik, Leipzig, Germany). As a criterion for skeletal stability the postoperative changes of SNB angle and Wits appraisal were determined. In 10 of 28 patients with mandibular advancement and in 10 of 21 individuals with mandibular setback, the Luhr positioning device was used intraoperatively to reproduce the condylar position. Mandibular joints of the remaining patients were positioned manually. The results were statistically worked up by means of unrelated t test at P = .05.

Results

Neither in advancement nor in setback surgery did the positioning device technique result in better outcomes for postoperative changes of SNB angle and Wits appraisal. The confidence intervals rather suggest equivalence of the data in both groups.

Conclusion

The use of positioning appliances does not lead to an improvement of skeletal stability. With the manual technique, equally stable results can be attained in advancement as well as in setback surgery.