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The International Journal of Adult Orthodontics & Orthognathic Surgery
(Published from 1986-2002)

Edited by Robert L. Vanarsdall, DDS and Raymond P. White, Jr, DDS, PhD

Continued by World Journal of Orthodontics.

ISSN 0742-1931

Publication:
The International Adult Orthodontics & Orthognathic Surgery
Spring
Volume 17, Issue 1

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Postoperative mandibular stability after orthognathic surgery in patients with mandibular protrusion and mandibular deviation

Wenli Lai, DDS, PhD, Kazuhiro Yamada, DDS, PhD, Kooji Hanada, DDS, PhD, Iyad M.Ali,DMD, Ritsuo Takagi, DDS, PhD, Tadaharu Kobayashi, DDS, PhD, Takafumi Hayashi, DDS, PhD

Skeletal stability and temporomandibular joint (TMJ) signs and symptoms were analyzed in 23 patients in whom mandibular protrusion and mandibular deviation had been corrected using bilateral sagittal split ramus osteotomy (BSSRO group, n=10) and unilateral SSRO and intraoral vertical ramus osteotomy (USSRO+IVRO group, n=13). Miniplate fixation was used in SSRO but no fixation was used in IVRO. The ratio of condylar bony change was 30.4% (7/23) and all condylar bony changes were seen on the deviated side. All preoperative signs and symptoms of TMJ disorders (4/13 patients in the USSRO+IVRO group and 2/10 patients in the BSSRO group) disappeared after surgery. Comparing the USSRO+IVRO group and the BSSRO group, in patients without condylar bony change, the mandible in both groups was stable anteriorly and horizontally after surgery, even though there was a larger horizontal mandibular movement in the USSRO+IVRO group during surgery. Comparing patients with condylar bony change versus no condylar bony change in the USSRO+IVRO group, postoperative horizontal mandibular displacement was significantly larger in the condylar bony change group than in the no condylar bony change group. These results support the idea that USSRO+IVRO can be useful in correcting mandibular deviation as well as improving signs and symptoms of TMJ disorders. However, it also seems important to be aware of the possibility of horizontal mandibular relapse in patients with condylar bony change. (Int J Adult Orthod Orthognath Surg 2002;17:1322)

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