Abstract
Objectives. To investigate the correlation between frontal gaps and skeletal stability after intraoral vertical ramus osteotomy (IVRO) for correction of mandibular prognathism. Materials and Methods. Thirty-three patients with frontal gaps after IVRO-based mandibular prognathism correction were included. Three lateral and frontal cephalometric radiographs were obtained: preoperatively (T1), immediately postoperatively (T2), and 2 years postoperatively (T3). Two linear measurements (menton [Me] and frontal gap) were compared from T1 to T3 (T21: immediate surgical changes; T32: postoperative stability; T31: 2-year surgical change). Data were analyzed using Pearson's correlation coefficient and multiple linear regression. Results. The T21 mean surgical horizontal change in the Me position was 12.4 ± 4.23 mm. Vertically, the mean downward Me movement was 0.6 ± 1.73 mm. The mean frontal gaps were 4.7 ± 2.68 mm and 4 ± 2.48 mm in the right and left gonial regions, respectively. Postoperative stability (T32) significantly correlated with the amount of setback. Frontal gaps did not have a significant effect on postoperative stability. However, multiple regression model (R 2 = 0.341, P = 0.017) showed value predictability, especially in the amount of setback. Conclusion. Frontal gaps occur after IVRO but have no significant effect on long-term postoperative skeletal stability. The primary risk factor for postoperative relapse remains the amount of mandibular setback.
Highlights
Skeletal discrepancy in the maxilla or mandible can be due to morphological malformation or asymmetry and tends to induce significant malocclusion and dentofacial deformity [1]
Mandibular prognathism refers to the prominent protrusion of the lower third portion of the facial skeleton
Combined orthodontic treatment and orthognathic surgery has been advocated as the major approach for correction of mandibular prognathism
Summary
Skeletal discrepancy in the maxilla or mandible can be due to morphological malformation or asymmetry and tends to induce significant malocclusion and dentofacial deformity [1]. Mandibular prognathism refers to the prominent protrusion of the lower third portion of the facial skeleton. This facial pattern is commonly seen among siblings and parents because of its strong heritability [2]. Combined orthodontic treatment and orthognathic surgery has been advocated as the major approach for correction of mandibular prognathism. Intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) are the two main surgical approaches for treating prognathic deformity of the mandible. We still performed 6-week IMF to avoid the movement of both segments during bone healing. To avoid postoperative lip numbness, we advocate the use of IVRO rather than SSRO for the treatment of mandibular prognathism
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