Are there risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy?

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• 作者：J.P. Verweij^a ; J.G. van Rijssel^a ; M. Fiocco^b ; ^c ; G. Mensink^a ; ^d ; P.J.J. Gooris^d ; J.P.R. van Merkesteyn^a ; ^{J.P.R.van_Merkesteyn@lumc.nl}
• 关键词：Orthognathic surgery ; Sagittal split osteotomy ; Inferior border defect ; Risk
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：45
• 期：2
• 页码：192-197
• 全文大小：610 K
• 卷排序：45

文摘

Bone defects of the inferior mandibular border (osseous inferior border defects) can cause unesthetic postoperative outcomes after bilateral sagittal split osteotomy (BSSO). The aim of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify risk factors for this complication.Materials and methodsThis retrospective study included consecutive patients who underwent BSSO for mandibular retrognathia. The primary outcome was the presence/absence of osseous inferior border defects. Predictors included the mandibular movement, rotation of the occlusal plane, postoperative proximal segment position, pattern of lingual fracture, occurrence of bad split, and presence of third molars.ResultsThe study sample consisted of 200 patients and had a mean follow-up of 13 months. The mean mandibular advancement and rotation was respectively 5.8 mm and 5.4° clockwise. Osseous inferior border defects were present in 7.0% of splits and in 12.5% of patients. Significant risk factors for inferior border defects included increased advancement, increased clockwise rotation, cranial rotation of the proximal segment, and a split originating in the lingual cortex.ConclusionIn conclusion, osseous inferior border defects occur significantly more often in cases with large mandibular advancement, increased clockwise rotation of the occlusal plane, malpositioning of the proximal segment, and a split originating in the lingual cortex.