Abstract
Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral verticosagittal ramus osteotomy, it can minimize the movement of the proximal segment. The changes in the intergonal distance of mandible and the angle of the ramus flaring in two methods of osteotomy have been compared in this study. Materials and Methods: In this randomized clinical trial, included 60 patients (32 males) with mandibular prognathism and without any asymmetry were selected and divided into two groups (n = 30). One group underwent bilateral sagittal split ramus osteotomy technique to achieve mandibular setback and the other by the intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner-ramal angle in the transverse plane were measured on radiographs preoperatively and 1 and 12 weeks postoperatively. Data were analyzed using covariance test with the significance level set at P 0.1). Conclusion: Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle.
Highlights
Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle
Osteotomy of the mandibular ramus by Bilateral Sagittal Split Ramus Osteotomy (BSSRO), which was first introduced by Trauner and Obwegeser in 1957, is widely used to correct mandibular prognathism and retrognathism [1]
Due to the desired bone contact resulting from this technique between the two segments and the possibility of full fixation of these segments, besides the support of the vast research conducted in this respect, BSSRO is considered as the conventional method in mandibular osteotomy [2]
Summary
Due to the desired bone contact resulting from this technique between the two segments and the possibility of full fixation of these segments, besides the support of the vast research conducted in this respect, BSSRO is considered as the conventional method in mandibular osteotomy [2] By this type of osteotomy and in order to set-back the mandible, the lateral cortex of the ramus is split and following the set back of the distal segment due to the bone contact between the sponge bones in the lateral aspect of the distal segment and the medial aspect of the proximal segment, the proximal segment is slightly drawn to the lateral side leaving triangular spaces in the anterior and posterior aspect of the bones’ contact sites. In 1992, Choung et al conducted research on the ramus diameter with the help of CT scan; they introduced a new technique named “Intraoral Vesico-Sagittal Ramus Osteotomy” (IVSRO) [7]
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