Korean J Orthod.  2015 Jan;45(1):3-12. 10.4041/kjod.2015.45.1.3.

Miniscrews versus surgical archwires for intermaxillary fixation in adults after orthognathic surgery

• Son S
• Kim SS
• Son WS
• Kim YI
• Kim YD
• Shin SH

• KMID: 2074817
• DOI: http://doi.org/10.4041/kjod.2015.45.1.3

Abstract

OBJECTIVE
We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea.
METHODS
All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery (T0), (b) 3 months after surgery (T1), and (c) 6 months after surgery (T2). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t-test procedure was used to compare the two groups.
RESULTS
After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from T0 to T1, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1).
CONCLUSIONS
This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.

Keyword

Microimplant; Surgery; Cephalometrics

MeSH Terms

Adult*
Humans
Incisor
Korea
Malocclusion
Orthognathic Surgery*
Orthognathic Surgical Procedures
Osteotomy
Osteotomy, Sagittal Split Ramus
Overbite

Figure

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  Figure 1 Intermaxillary fixation types. (A) Surgical archwire fixation and (B) Orthodontic miniscrew fixation.

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  Figure 2 Landmarks and reference planes. S, Sella; N, Nasion; Po, Porion; Or, Orbitale; ANS, anterior nasal spine; PNS, posterior nasal spine; Me, Menton; U1E, incisal edge of maxillary central incisor (U1); U1A, root apex of U1; L1E, incisal edge of mandibular incisor (L1), L1A: root apex of L1; U6MBC, mesiobuccal cusp tip (MBC) of maxillary first molar; L6MBC, MBC of mandibular first molar; Frankfort horizontal plane (FH plane), line from Po to Or; N-perpendicular plane (N-perpend plane), perpendicular line to FH plane passing through Nasion.

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  Figure 3 Cephalometric measurements. 1, FH-palatal plane; 2, FH-maxillary occlusal plane; 3, FMA; 4, U1 to SN; 5, U1-X; 6, U1-Y; 7, U6-X; 8, U6-Y; 9, U1-palatal; and 10, U6-palatal. Refer to Figure 2 and Table 1 for the definition of each measurements.

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  Figure 4 Cephalometric measurements of the mandible. 1, L1-mandibular plane; 2, L6-mandibular plane; 3, L1 to MnOP, and 4, IMPA. Refer to Figure 2 and Table 1 for the definition of each measurements.

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  Figure 5 Cephalometric measurements of interdental relationship. 1, Interincisal angle; 2, incisor overjet; and 3, incisor overbite. Refer to Figure 2 and Table 1 for the definition of each measurements.

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