{"title":"Sagittal Split Ramus Osteotomy Without Segmental Fixation in Skeletal Class II.","authors":"Shun Narahara, Rena Shido, Takamitsu Koga, Emi Moriuchi, Tomohiro Yamada, Seigo Ohba, Tatsuo Shirota","doi":"10.1097/SCS.0000000000011016","DOIUrl":null,"url":null,"abstract":"<p><p>The new orthognathic treatment strategy of non-segmental fixation (non-fix) sagittal split ramus osteotomy (SSRO) with jaw exercise initiation on the second postoperative day, the so-called physiological positioning strategy (PPS), induces good skeletal stability with few temporomandibular joint (TMJ) symptoms after surgery in skeletal class III. This study aimed to clarify whether non-fix SSRO with modified PPS can be applied to skeletal class II. This retrospective study included skeletal class II patients who underwent non-fix SSRO to correct mandibular retrognathia. Jaw exercise was initiated within 10 postoperative days. Cephalometric analyses were performed before (T1), immediately after (T2), and more than 6 months after (T3) surgery. Skeletal and dental stability, and TMJ symptoms were evaluated. Twelve patients (2 men, 10 women; mean age 22.9±7.1 y) were included. The mean mandibular advancement was 6.8±1.8 mm. angle between S-N and N-B. was 73.6±4.5, 77.1±3.9, and 75.1±4.4 degrees at T1, T2, and T3, meaning 60.5% relapse. The Menton moved forward by 6.3 mm from T1 to T2 and relapsed by 4.6 mm at T3. The duration of intermaxillary traction showed a moderate negative correlation with angle between S-N and N-B. relapse (r=-0.42, P=0.1787). Only 2 TMJ symptoms (2/24, 8.3%) developed postoperatively. This study suggests that non-fix SSRO with modified PPS is a suitable method for skeletal class II malocclusion. Further research with a larger sample size and detailed analysis of the effect of intermaxillary traction on skeletal stability after surgery is needed.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Craniofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SCS.0000000000011016","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
The new orthognathic treatment strategy of non-segmental fixation (non-fix) sagittal split ramus osteotomy (SSRO) with jaw exercise initiation on the second postoperative day, the so-called physiological positioning strategy (PPS), induces good skeletal stability with few temporomandibular joint (TMJ) symptoms after surgery in skeletal class III. This study aimed to clarify whether non-fix SSRO with modified PPS can be applied to skeletal class II. This retrospective study included skeletal class II patients who underwent non-fix SSRO to correct mandibular retrognathia. Jaw exercise was initiated within 10 postoperative days. Cephalometric analyses were performed before (T1), immediately after (T2), and more than 6 months after (T3) surgery. Skeletal and dental stability, and TMJ symptoms were evaluated. Twelve patients (2 men, 10 women; mean age 22.9±7.1 y) were included. The mean mandibular advancement was 6.8±1.8 mm. angle between S-N and N-B. was 73.6±4.5, 77.1±3.9, and 75.1±4.4 degrees at T1, T2, and T3, meaning 60.5% relapse. The Menton moved forward by 6.3 mm from T1 to T2 and relapsed by 4.6 mm at T3. The duration of intermaxillary traction showed a moderate negative correlation with angle between S-N and N-B. relapse (r=-0.42, P=0.1787). Only 2 TMJ symptoms (2/24, 8.3%) developed postoperatively. This study suggests that non-fix SSRO with modified PPS is a suitable method for skeletal class II malocclusion. Further research with a larger sample size and detailed analysis of the effect of intermaxillary traction on skeletal stability after surgery is needed.
期刊介绍:
The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial surgery, maxillofacial surgery and pediatric plastic surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The journal publishes original articles, scientific reviews, editorials and invited commentary, abstracts and selected articles from international journals, and occasional international bibliographies in craniofacial surgery.