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• W2085699516 abstract "The bilateral sagittal split osteotomy (BSSO) is the most commonly performed procedure by oral and maxillofacial surgeons for the correction of mandibular deformities. 1 Proffit W.R. White Jr, R.P. The need for surgical orthodontic treatment. in: Proffit W.R. White Jr, R.P. Surgical Orthodontic Treatment. Mosby, St Louis, MO1991: 18-19 Google Scholar The surgical technique and design have been modified over the years to increase predictability of splitting, increase segment overlap, and minimize soft tissue stripping. Although instrumentation and sequencing vary among surgeons, the basic bony design of the BSSO is fairly standard (Fig 1). This osteotomy configuration, and bony overlap, allows for a variety of fixation techniques. Interosseous wiring with maxillomandibular fixation (MMF) and/or skeletal fixation has proved to be reasonably stable and predictable, with relapse toward the presurgical mandibular position, often with dental compensatory changes. 2 Watzke I.M. Turvey T.A. Phillips C. et al. Stability of mandibular advancement by sagittal osteotomy with screw and wire fixation A comparative study. J Oral Maxillofac Surg. 1990; 48: 108 Abstract Full Text PDF PubMed Scopus (78) Google Scholar , 3 Keeling S.D. Dolce C. Van Sickels J.E. et al. A comparative study of skeletal and dental stability between rigid and wire fixation for mandibular advancement. Am J Orthod Dentofac Orthop. 2000; 117: 638 Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar , 4 Ellis 3rd, E. Reynolds S. Carlson D.S. Stability of the mandible following advancement A comparison of three postsurgical fixation techniques. Am J Orthod Dentofac Orthop. 1988; 94: 38 Abstract Full Text PDF PubMed Scopus (49) Google Scholar Beginning in the mid-1980s, rigid internal fixation (RIF) was used to stabilize BSSO segments, occasionally in conjunction with a period of MMF (2 to 6 weeks). Relapse generally occurred with larger movements (>10 mm). 5 McDonald W.R. Stability of mandibular lengthening A comparison of moderate and large advancements. Oral Maxillofac Surg Clin North Am. 1990; 2: 729 Google Scholar , 6 Shardt-Sacco D. Turvey T.A. Proffit W.R. Stability of large advancements greater than 8 mm. J Oral Maxillofac Surg. 1996; 54: 105 PubMed Google Scholar , 7 Van Sickels J.E. A comparative study of bicortical screw and suspension wire versus bicortical screws in large mandibular advancements. J Oral Maxillofac Surg. 1991; 49: 1293 Abstract Full Text PDF PubMed Scopus (43) Google Scholar Numerous studies have been published on the stability of BSSO rigidly fixated with bicortical screws and no postoperative MMF. 8 Dolce C. Hatch J.P. Van Sickels J.E. et al. Rigid versus wire fixation for mandibular advancement Skeletal and dental changes after five years. Am J Orthod Dentofac Orthop. 2002; 121: 610 Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar , 9 Thomas P.M. Tucker M.R. Prewitt J.R. et al. Early skeletal and dental changes following mandibular advancement and RIF. Int J Adult Orthod Orthognath Surg. 1986; 3: 171 Google Scholar , 10 Van Sickels J.E. Larsen A.J. Thrash W.J. Relapse after rigid fixation of mandibular advancement. J Oral Maxillofac Surg. 1986; 44: 698 Abstract Full Text PDF PubMed Scopus (129) Google Scholar , 11 Perrott D.H. Lu Y.F. Pogrel M.A. et al. Stability of sagittal split osteotomies A comparison of three stabilization techniques. Oral Surg Oral Med Oral Pathol. 1994; 78: 696 Abstract Full Text PDF PubMed Scopus (23) Google Scholar Not only is MMF unnecessary, and less acceptable to patients, when combined with rigid fixation of sagittal split osteotomies, it may lead to adverse affects on the temporomandibular joint. 12 White C.S. Dolwick M.F. Preference and variance of temporomandibular dysfunction in orthognathic surgery patients. Int J Adult Orthod Orthognath Surg. 1992; 7: 7 PubMed Google Scholar" @default.
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• W2085699516 title "Bicortical screw stabilization of sagittal split osteotomies" @default.
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