Stability After Bilateral Sagittal Split Osteotomy Setback Surgery With Rigid Internal Fixation: A Systematic Review
Purpose
The purpose of this systematic review was to evaluate relapse and its causes in bilateral sagittal split setback osteotomy with rigid internal fixation.
Materials and Methods
Literature research was done in databases such as PubMed, Ovid, the Cochrane Library, and Google Scholar Beta. From the original 488 articles identified, 14 articles were finally included. Only 5 studies were prospective and 9 retrospective. The range of postoperative study records was from 6 weeks to 12.7 years.
Results
The horizontal short-term relapse was between 9.9% and 62.1% at point B and between 15.7% and 91.3% at pogonion. Long-term relapse was between 14.9% and 28.0% at point B and between 11.5% and 25.4% at pogonion.
Conclusions
Neither large increase nor decrease of relapse was seen when short-term values were compared with long-term. Bilateral sagittal split osteotomy for mandibular setback in combination with orthodontics is an effective treatment of skeletal Class III and a stable procedure in the short- and long-term. The etiology of relapse is multifactorial: the proper seating of the condyles, the amount of setback, the soft tissue and muscles, remaining growth and remodeling, and gender were identified. Age did not show any correlations. To obtain reliable scientific evidence, further short- and long-term research of bilateral sagittal split osteotomy setback with rigid internal fixation should exclude additional surgery, ie, genioplasty or maxillary surgery, and include correlation statistics.
⁎Senior Assistant, Department of Orthodontics, University of Geneva, Geneva, Switzerland.
†Senior Staff, Department of Orthodontics, University of Bern, Bern, Switzerland.
Address correspondence and reprint requests to Dr Joss: Faculté de médecine, Section de médecine dentaire, Rue Barthélémy-Menn 19, CH-1205 Genève, Switzerland
ABSTRACT