Volume 67, Issue 11 , Pages 2344-2353, November 2009
Skeletal Stability and Complications of Bilateral Sagittal Split Osteotomies and Mandibular Distraction Osteogenesis: An Evidence-Based Review
Purpose
To provide an evidence-based review comparing the skeletal stability and complications of bilateral sagittal split osteotomies (BSSOs) and mandibular distraction osteogenesis (MDO) in the treatment of mandibular hypoplasia.
Materials and Methods
A Medline search from January 1957 to December 2007 was performed wherein articles were retrieved on the basis of a set of inclusion and exclusion criteria. Data on mean skeletal stability and complications for the 2 techniques were retrieved from these articles.
Results
Based on the articles about stability, patients undergoing BSSO or MDO with an advancement or lengthening between 6 and 10 mm showed a similar mean skeletal relapse of 15.0% and 17.1%, respectively, within postoperative months 6 to 12. Greater skeletal relapse was reported for BSSO patients with high mandibular plane angles compared with normal mandibular plane angle patients (29.6% vs 11.3%). Based on the articles about complications, patients who underwent MDO showed a lower incidence of persistent inferior alveolar nerve disturbance (2.9%) and condylar resorption (1.4%) compared with BSSO patients, in whom the incidence of these conditions was 27.8% and 6.1%, respectively.
Conclusion
Both BSSO and MDO showed similar relapse rates for mandibular advancements between 6 and 10 mm. Both techniques may also share similar risk factors for skeletal relapse. BSSO has a higher incidence of persistent neurosensory disturbances and condylar resorption than MDO. Randomized controlled trials of these 2 techniques are still lacking.
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PII: S0278-2391(08)01154-3
doi:10.1016/j.joms.2008.07.003
© 2009 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Volume 67, Issue 11 , Pages 2344-2353, November 2009
