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Effect of perioperative buccal fracture of the proximal segment on postoperative stability after sagittal split ramus osteotomy

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ÀÌ»óÀ±, ¾çÈÆÁÖ, ÇÑÁ¤ÁØ, Ȳ¼øÁ¤,
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ÀÌ»óÀ± ( Lee Sang-Yoon ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
¾çÈÆÁÖ ( Yang Hoon-Joo ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
ÇÑÁ¤ÁØ ( Han Jeong-Joon ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
Ȳ¼øÁ¤ ( Hwang Soon-Jung ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery

Abstract


Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery.

Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture.

Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible.

Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

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Mandibular fracture; Sagitta split ramus osteotomy; Fracture healing; Postoperative stability

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