Stability of two-jaw surgery for mandibular prognathism

Kwon, Tae Geon

Abstract

The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1. The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2. Although there was no significant relapse tendancy was observed at chin points, the screw tip landmarks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3. According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not influenced the maxillary and mandibular relapse.