Clinical Comparative Study between Sagittal Split Ramus Osteotomy and Intraoral Vertical Ramus Osteotomy for Mandibular Setback
The most frequently used techniques for correcting skeletal Class III deformity are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). The purpose of this study was to compare the clinical outcome including skeletal stability after SSRO with semirigid fixation and I...
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| Published in | Nihon Gaku Henkeishō Gakkai zasshi Vol. 20; no. 3; pp. 205 - 210 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
THE JAPANESE SOCIETY FOR JAW DEFORMITIES
2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-7048 1884-5045 1884-5045 |
| DOI | 10.5927/jjjd.20.205 |
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| Abstract | The most frequently used techniques for correcting skeletal Class III deformity are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). The purpose of this study was to compare the clinical outcome including skeletal stability after SSRO with semirigid fixation and IVRO. The subjects of this study were 23 patients who underwent SSRO for mandibular setback with semirigid fixation by titanium miniplate and 20 patients who underwent IVRO for mandibular setback without interosseous fixation. The mean period of maxillo-mandibular fixation was 5.1 days in the SSRO group and 7.3 days in the IVRO group. The evaluation items were skeletal changes, operation time, blood loss, sensory disturbance, temporomandibular joint (TMJ) sound and mandibular range of motion (ROM). Compared with the SSRO group, the B-point and pogonion moved significantly posteriorly in the IVRO at more than 6 months after surgery. Operation time, blood loss and occurrence of sensory disturbance were also less than those in the SSRO group. There were no significant differences in TMJ sound and ROM. The results of this study showed that both methods had minimal relapse and no significant difference in comparison by measurement of B-point and pogonion. In conclusion, both methods are effective for correcting skeletal Class III malocclusion, and the surgical method should be selected in consideration of each clinical distinction. |
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| AbstractList | The most frequently used techniques for correcting skeletal Class III deformity are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). The purpose of this study was to compare the clinical outcome including skeletal stability after SSRO with semirigid fixation and IVRO. The subjects of this study were 23 patients who underwent SSRO for mandibular setback with semirigid fixation by titanium miniplate and 20 patients who underwent IVRO for mandibular setback without interosseous fixation. The mean period of maxillo-mandibular fixation was 5.1 days in the SSRO group and 7.3 days in the IVRO group. The evaluation items were skeletal changes, operation time, blood loss, sensory disturbance, temporomandibular joint (TMJ) sound and mandibular range of motion (ROM). Compared with the SSRO group, the B-point and pogonion moved significantly posteriorly in the IVRO at more than 6 months after surgery. Operation time, blood loss and occurrence of sensory disturbance were also less than those in the SSRO group. There were no significant differences in TMJ sound and ROM. The results of this study showed that both methods had minimal relapse and no significant difference in comparison by measurement of B-point and pogonion. In conclusion, both methods are effective for correcting skeletal Class III malocclusion, and the surgical method should be selected in consideration of each clinical distinction. |
| Author | TAKAHASHI, TETSU SAKAI, AKIYUKI NAGAYAMA, JUNICHIRO SAKAI, KAORI YAMAUCHI, KENSUKE KANEUJI, TAKESHI NOGAMI, SHINNOSUKE YAMASHITA, YOSHIHIRO |
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| Cites_doi | 10.5794/jjoms.39.623 10.5794/jjoms.47.49 10.5794/jjoms.34.88 10.1016/S0007-117X(63)80067-0 10.1016/j.tripleo.2006.12.024 10.5794/jjoms.48.195 10.1055/s-2008-1064841 10.1016/0278-2391(89)90221-8 10.5927/jjjd1991.7.120 10.2319/122707-604.1 10.1016/j.ijom.2008.04.010 10.1016/j.joms.2007.09.008 |
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| References | 19) Varas, R.B., et al.: Functional and radiographic long-term results after bad split in orthognathic surgery, Int J Oral Maxillofac Surg, 37: 606-611, 2008. 5) 川村 仁，他：下顎骨の変形に対する口内法による下顎枝垂直骨切り術，日口外誌，34：88-97，1988 14) Bell, W.H., et al.: Treatment of temporomandibular joint dysfunctionby intraoral vertical ramus osteotomy, Int J Adult Orthod Orthognathi Surg, 5: 9-27, 1990. 6) Yoshioka, I., et al.: Vertical ramus versus sagittal split osteotomies: comparison of stability after mandibular setback, J Oral Maxillofac Surg, 66: 1138-1144, 2008. 20) 藤沢 徹，他：下顎枝垂直骨切り術後に生じた顔面動脈の仮性動脈瘤に対し塞栓術で対応した1例，日口外誌，48：195-198，2002 10) Hall, H.D., et al.: Evaluation and refinement of the intraoral vertical subcondylar osteotomy, J Oral Surg, 33: 333-341, 1975. 13) Zhao, Q., et al.: Changes in the temporomandibular joint after mandibular setback surgery in monkeys: intraoral vertical versus sagittal split ramus osteotomy, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 104: 329-337, 2007. 3) 川村 仁，他：チタンミニプレート固定を併用した下顎枝矢状分割術，日顎変形誌，1：105-112，1990 1) Costa, F., et al.: Stability of sagittal split osteotomy used to correct Class III malocclusion: review of the literature, Int J Adult Orthodon Orthognath Surg, 16: 121-129, 2001. 7) Obwegeser, H.: The indications for the correction of mandibular deformity by the sagittal splitting technique, Br J Oral Surg, 1: 157-171, 1964. 16) 伊東正志，他：顎変形症を伴う顎関節症患者における下顎枝垂直骨切り術の臨床評価とMRIによる検討，日口外誌，47：49-51，2001 17) Nitzan, D.W., et al.: Temporomandibular joint fibrous ankylosis following orthognathic surgery, Report of eight cases, Int J Adult Orthod Orthognathi Surg, 4: 7-11, 1989. 8) Dal Pont, G.: Retromolar osteotomy for the correction of prognathism, J Oral Surg Anesth & Hosp D Serv, 19: 42-47, 1961. 9) Kitahara, T., et al.: Hard and soft tissue stability of orthognathic surgery, Angle Orthod, 79: 158-165, 2009. 11) Phillips, C., et al.: Skeletal alterations following TOVRO or BSSO procedures, Int J Adult Orthodon Orthognath Surg, 3: 203: 203-213, 1986. 18) Hackney F.L., et al.: Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation, J Oral Maxillofac Surg, 47: 223-227, 1989. 2) 代元巳弥，他：骨格性下顎前突症に対する下顎枝垂直骨切り術（IVRO）適用後の下顎骨および咬合に関する術後安定性―下顎枝矢状分割術（SSRO）との比較―，日顎変形誌，7：120-128，1997 4) Walter, M.J., et al.: Analysis postsurgical neurologic alteration the trigeminal nerve, J Oral Surg, 37: 410-414, 1979. 12) 長坂 浩：骨格性下顎前突症の顎矯正手術前後の下顎頭位に関する研究，日口外誌，39：623-638，1993 15) Bell, W.H., et al.: Condyle position and mobility before and after intraoral vertical ramus osteotomies and neuromuscular rehabilitation, Int J Adult Orthod Orthognathi Surg, 6: 97-104, 1991. 11 12 13 14 15 16 17 18 19 1 2 3 4 5 6 7 8 9 20 10 |
| References_xml | – reference: 17) Nitzan, D.W., et al.: Temporomandibular joint fibrous ankylosis following orthognathic surgery, Report of eight cases, Int J Adult Orthod Orthognathi Surg, 4: 7-11, 1989. – reference: 10) Hall, H.D., et al.: Evaluation and refinement of the intraoral vertical subcondylar osteotomy, J Oral Surg, 33: 333-341, 1975. – reference: 19) Varas, R.B., et al.: Functional and radiographic long-term results after bad split in orthognathic surgery, Int J Oral Maxillofac Surg, 37: 606-611, 2008. – reference: 3) 川村 仁，他：チタンミニプレート固定を併用した下顎枝矢状分割術，日顎変形誌，1：105-112，1990． – reference: 11) Phillips, C., et al.: Skeletal alterations following TOVRO or BSSO procedures, Int J Adult Orthodon Orthognath Surg, 3: 203: 203-213, 1986. – reference: 9) Kitahara, T., et al.: Hard and soft tissue stability of orthognathic surgery, Angle Orthod, 79: 158-165, 2009. – reference: 18) Hackney F.L., et al.: Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation, J Oral Maxillofac Surg, 47: 223-227, 1989. – reference: 15) Bell, W.H., et al.: Condyle position and mobility before and after intraoral vertical ramus osteotomies and neuromuscular rehabilitation, Int J Adult Orthod Orthognathi Surg, 6: 97-104, 1991. – reference: 12) 長坂 浩：骨格性下顎前突症の顎矯正手術前後の下顎頭位に関する研究，日口外誌，39：623-638，1993． – reference: 13) Zhao, Q., et al.: Changes in the temporomandibular joint after mandibular setback surgery in monkeys: intraoral vertical versus sagittal split ramus osteotomy, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 104: 329-337, 2007. – reference: 20) 藤沢 徹，他：下顎枝垂直骨切り術後に生じた顔面動脈の仮性動脈瘤に対し塞栓術で対応した1例，日口外誌，48：195-198，2002． – reference: 5) 川村 仁，他：下顎骨の変形に対する口内法による下顎枝垂直骨切り術，日口外誌，34：88-97，1988． – reference: 7) Obwegeser, H.: The indications for the correction of mandibular deformity by the sagittal splitting technique, Br J Oral Surg, 1: 157-171, 1964. – reference: 4) Walter, M.J., et al.: Analysis postsurgical neurologic alteration the trigeminal nerve, J Oral Surg, 37: 410-414, 1979. – reference: 6) Yoshioka, I., et al.: Vertical ramus versus sagittal split osteotomies: comparison of stability after mandibular setback, J Oral Maxillofac Surg, 66: 1138-1144, 2008. – reference: 1) Costa, F., et al.: Stability of sagittal split osteotomy used to correct Class III malocclusion: review of the literature, Int J Adult Orthodon Orthognath Surg, 16: 121-129, 2001. – reference: 2) 代元巳弥，他：骨格性下顎前突症に対する下顎枝垂直骨切り術（IVRO）適用後の下顎骨および咬合に関する術後安定性―下顎枝矢状分割術（SSRO）との比較―，日顎変形誌，7：120-128，1997． – reference: 16) 伊東正志，他：顎変形症を伴う顎関節症患者における下顎枝垂直骨切り術の臨床評価とMRIによる検討，日口外誌，47：49-51，2001． – reference: 14) Bell, W.H., et al.: Treatment of temporomandibular joint dysfunctionby intraoral vertical ramus osteotomy, Int J Adult Orthod Orthognathi Surg, 5: 9-27, 1990. – reference: 8) Dal Pont, G.: Retromolar osteotomy for the correction of prognathism, J Oral Surg Anesth & Hosp D Serv, 19: 42-47, 1961. – ident: 17 – ident: 3 – ident: 4 – ident: 12 doi: 10.5794/jjoms.39.623 – ident: 1 – ident: 16 doi: 10.5794/jjoms.47.49 – ident: 10 – ident: 5 doi: 10.5794/jjoms.34.88 – ident: 14 – ident: 15 – ident: 7 doi: 10.1016/S0007-117X(63)80067-0 – ident: 13 doi: 10.1016/j.tripleo.2006.12.024 – ident: 20 doi: 10.5794/jjoms.48.195 – ident: 11 doi: 10.1055/s-2008-1064841 – ident: 18 doi: 10.1016/0278-2391(89)90221-8 – ident: 2 doi: 10.5927/jjjd1991.7.120 – ident: 9 doi: 10.2319/122707-604.1 – ident: 19 doi: 10.1016/j.ijom.2008.04.010 – ident: 6 doi: 10.1016/j.joms.2007.09.008 – ident: 8 |
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| Title | Clinical Comparative Study between Sagittal Split Ramus Osteotomy and Intraoral Vertical Ramus Osteotomy for Mandibular Setback |
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