Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1138-1144, June 2008

Vertical Ramus Versus Sagittal Split Osteotomies: Comparison of Stability After Mandibular Setback

  • Izumi Yoshioka, DDS, PhD

      Affiliations

    • Assistant Professor, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Yoshioka: Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Manazuru 2-6-1, Kokurakita, Kitakyushu, Fukuoka, Japan
  • ,
  • Amit Khanal, BDS, PhD

      Affiliations

    • Postgraduate Student, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
  • ,
  • Kazuhiro Tominaga, DDS, PhD

      Affiliations

    • Professor and Chair, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
  • ,
  • Akihisa Horie, DDS, PhD

      Affiliations

    • Assistant Professor, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
  • ,
  • Norihiko Furuta, DDS, PhD

      Affiliations

    • Assistant Professor, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
  • ,
  • Jinichi Fukuda, DDS, PhD

      Affiliations

    • Professor, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.

Purpose

Intraoral vertical ramus osteotomy (IVRO) offers some advantages over sagittal split ramus osteotomy (SSRO) for treatment of the prognathic patient. The purpose of this study was to compare the postoperative changes of proximal and distal segments after IVRO and SSRO with semirigid internal fixation.

Patients and Methods

Thirty Japanese adults with a diagnosis of prognathic mandible were randomized to undergo either IVRO (n = 15) or SSRO (n = 15) according to an adaptive random assignment procedure. The postoperative changes of the proximal and distal segments were assessed with posteroanterior and lateral cephalograms.

Results

Compared with the SSRO group, the B-point and pogonion moved significantly posteriorly and inferiorly in the IVRO group from 1 month to 3 months after surgery. At 1 year after surgery, there was no significant difference between the 2 groups in the horizontal and vertical stability of the B-point and the pogonion. In the IVRO group, the gonion deviated significantly laterally from 1 week until 1 month after surgery as compared with that of the SSRO group. There was a significant correlation between the amount of setback and the amount of lateral gonial deviation in the IVRO group from 1 week to 1 year after surgery.

Conclusions

Although in IVRO cases, distal segments moved posteriorly and inferiorly immediately after the release of maxillomandibular fixation, the stability after IVRO is equal to that after SSRO with semirigid internal fixation.

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PII: S0278-2391(07)01821-6

doi:10.1016/j.joms.2007.09.008

Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1138-1144, June 2008