Year-end Sale % OFF 
Abstract
Sagittal split ramus osteotomy (SSRO) with large mandibular advancements is a common surgical procedure and could be indicated for patients with sleep apnoea. As a large variety of fixation methods is used for the stabilisation of SSRO, a biomechanical test model was used to analyse which fixation technique was most stable. For this in vitro study, 80 polyurethane hemimandibles with a prefabricated SSRO were used as substrates. Loads in Newtons were recorded at displacements of the mandibular incisive edge at 1mm, 3mm and 5mm. The samples were divided into two groups: mandibular advancements of 10mm and 15mm. In both groups, four fixation techniques were used: (A) one four-hole miniplate; (B) two four-hole miniplates; (C) one four-hole miniplate plus one bicortical screw; and (D) three bicortical screws in an inverted-L arrangement. In group 1, three bicortical screws resulted in the best stability, and in group 2, two miniplates resulted in the best stability. The use of two miniplates did not show significant differences between both groups. Other fixation methods showed more stability with 10mm advancements. This study therefore suggests that in SSRO with advancements exceeding 10mm, the use of two miniplates is the optimal means of providing rigid fixation.
Highlights
Large mandibular advancement after sagittal split ramus osteotomy (SSRO) is a procedure indicated for the treatment of patients with a pronounced skeletal class 2 malocclusion and/or obstructive sleep apnoea (OSA)
Dure is generally combined with a Le Fort 1 osteotomy with advancement and rotation of the occlusal plane, referred to as maxillomandibular advancement surgery (MMA)
With the lack of research regarding the stability of fixation methods beyond 10 mm, it could be hypothesised that fixation with three bicortical screws is the gold standard for the most rigid fixation
Summary
Large mandibular advancement after sagittal split ramus osteotomy (SSRO) is a procedure indicated for the treatment of patients with a pronounced skeletal class 2 malocclusion and/or obstructive sleep apnoea (OSA). The effect of large MMA has proved highly effective in increasing the size of the upper airway and reducing the apnoea/hypopnoea index (AHI) in OSA patients.[1,2,3,4]. (hybrid).[5] A biomechanical evaluation study in which masticatory movements are simulated is the in vitro technique that is commonly used to test fixation stability. This provides the operator with fundamental knowledge on which to base the choice of a specific fixation method. More research regarding fixation stability in these large advancements is essential, since they are often necessary in the treatment of OSA patients, and there is reason to believe that they may be even more successful in patient-tailored treatment.[10,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
