A long-term comparative study of two rigid internal fixation techniques in terms of masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy

Abstract

Bilateral sagittal split ramus osteotomy (BSSO) is widely used to treat mandibular prognathism. Several methods have been described for fixation of the bony segments. This study compared two methods of rigid fixation (bicortical screws and monocortical miniplates) to identify differences in postoperative masticatory function and neurosensory disturbance after 5 years of mandibular set-back correction. 77 women who had undergone BSSO for Class III malocclusion were reviewed, and masticatory functions and neurosensory recovery were examined with the appropriate indicators pre- and postoperatively (at approximately 1 month, and 1, 2, 3, 4, and 5 years). Masticatory function exhibited similar recovery patterns in both groups. Orthognathic surgery improved occlusal force and occlusal contact area, but longer than 4 years after surgery may be required for postoperative occlusal functions in prognathic patients to reach the level of healthy subjects. The groups showed no significant differences in the recovery of parameters of masticatory functions and neurosensory disturbance even 5 years after surgery. In the evaluation of temporomandibular joint function using the Helkimo index, the score was significantly higher for the screw group than for the miniplate group. This suggests that BSSO fixed with miniplates may offer a relatively safe and reliable procedure yielding adequate results and high patient satisfaction.