Mandibular sagittal split osteotomy vs mandibular distraction osteogenesis in treatment of non-syndromic skeletal class II patients

Abstract

Mandibular retrognathia is a common skeletal congenital dysgnathia. In many cases of skeletal class II patients require the surgical operation. Orthognatic surgery offers mandibular bilateral sagittal split osteotomy (BSSO) as the most common procedure to make the advancement of the mandible. However, the alternative, mandibular distraction osteogenesis (MDO), is prevalent nowadays and beneficial in particular cases. The purpose of this study is to show the effect of MDO and BSSO done on 20 patients at Specialist Children's Hospital in Olsztyn, Poland between 2011 and 2013, performed by the same surgeon – KD. Authors would like to present the details of treatment planning and management of these methods as well as the protocol of usage of the distraction device. The sample consisted of 74 lateral cephalometric X-rays. Criteria for cephalometric comparison were angular cephalometric variables: SNB and SN/GoGn (Steiner analysis). The criteria for inclusion into this study were as follows: males and females with skeletal class II pattern plus dentofacial and dental abnormalities like skeletal open bite. The mean age of the subjects was 17.9 years. Our comparison study showed that there was no statistically significant difference between results of BSSO postoperatively and MDO post-distraction. However, there is a need of long-term data on stability of both methods. Study shows that MDO may offer another option for treatment of skeletal class II malocclusions in growing patients and after growth spurt.