Rigid versus wire fixation for mandibular advancement: Skeletal and dental changes after 5 years
| Autor: | Joseph E. Van Sickels, Calogero Dolce, John P. Hatch, John D. Rugh |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Chin Adolescent Cephalometry Overjet Bone Screws Dentistry Orthodontics Mandible Retrognathia Malocclusion Angle Class II Overbite Immobilization Fixation (surgical) Incisor Recurrence medicine Humans Prospective Studies Craniofacial Analysis of Variance Chi-Square Distribution business.industry Craniometry medicine.disease Jaw Fixation Techniques Sagittal plane Treatment Outcome medicine.anatomical_structure Female Malocclusion business Mandibular Advancement Bone Wires Follow-Up Studies |
| Zdroj: | American Journal of Orthodontics and Dentofacial Orthopedics. 121:610-619 |
| ISSN: | 0889-5406 |
| DOI: | 10.1067/mod.2002.123341 |
| Popis: | The bilateral sagittal split osteotomy (BSSO) is the most common surgical procedure for the correction of mandibular retrognathism. Commonly, the proximal and distal segments are fixated together with either wire or rigid screws or plates. The purpose of this study was to compare long-term (5 years) skeletal and dental changes between wire and rigid fixation after BSSO. In this multisite, prospective, randomized clinical trial, the rigid fixation group received three 2-mm bicortical position screws, and the wire fixation group received inferior border wires and 6 weeks of skeletal maxillomandibular fixation with 24-gauge wires. Cephalometric films were obtained 2 weeks before surgery and at 1 week, 8 weeks, 6 months, 1 year, 2 years, and 5 years after surgery. Linear cephalometric changes were referenced to a cranial base coordinate system. Before surgery, both groups were comparable with respect to linear and angular measurements of craniofacial morphology. Both groups underwent similar surgical changes. Skeletal and dental movements occurred in both groups throughout the study period. Five years after surgery, the wire group had 2.2 mm (42%) of sagittal skeletal relapse, while the rigid group remained unchanged from immediately postsurgery. Surprisingly, at 5 years, both groups had similar changes in overbite and overjet. This was attributed to dental changes in the maxillary and mandibular incisors. Although rigid fixation is more stable than wire fixation for maintaining the skeletal advancement after a BSSO, the incisor changes made the resultant occlusions of the 2 groups indistinguishable. |
| Databáze: | OpenAIRE |
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