Andrew Ow1, Lim Kwong Cheung. 1. Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong Special Administrative Region.
Abstract
PURPOSE: To provide an evidence-based review comparing the skeletal stability and complications of bilateral sagittal split osteotomies (BSSOs) and mandibular distraction osteogenesis (MDO) in the treatment of mandibular hypoplasia. MATERIALS AND METHODS: A Medline search from January 1957 to December 2007 was performed wherein articles were retrieved on the basis of a set of inclusion and exclusion criteria. Data on mean skeletal stability and complications for the 2 techniques were retrieved from these articles. RESULTS: Based on the articles about stability, patients undergoing BSSO or MDO with an advancement or lengthening between 6 and 10 mm showed a similar mean skeletal relapse of 15.0% and 17.1%, respectively, within postoperative months 6 to 12. Greater skeletal relapse was reported for BSSO patients with high mandibular plane angles compared with normal mandibular plane angle patients (29.6% vs 11.3%). Based on the articles about complications, patients who underwent MDO showed a lower incidence of persistent inferior alveolar nerve disturbance (2.9%) and condylar resorption (1.4%) compared with BSSO patients, in whom the incidence of these conditions was 27.8% and 6.1%, respectively. CONCLUSION: Both BSSO and MDO showed similar relapse rates for mandibular advancements between 6 and 10 mm. Both techniques may also share similar risk factors for skeletal relapse. BSSO has a higher incidence of persistent neurosensory disturbances and condylar resorption than MDO. Randomized controlled trials of these 2 techniques are still lacking.
PURPOSE: To provide an evidence-based review comparing the skeletal stability and complications of bilateral sagittal split osteotomies (BSSOs) and mandibular distraction osteogenesis (MDO) in the treatment of mandibular hypoplasia. MATERIALS AND METHODS: A Medline search from January 1957 to December 2007 was performed wherein articles were retrieved on the basis of a set of inclusion and exclusion criteria. Data on mean skeletal stability and complications for the 2 techniques were retrieved from these articles. RESULTS: Based on the articles about stability, patients undergoing BSSO or MDO with an advancement or lengthening between 6 and 10 mm showed a similar mean skeletal relapse of 15.0% and 17.1%, respectively, within postoperative months 6 to 12. Greater skeletal relapse was reported for BSSO patients with high mandibular plane angles compared with normal mandibular plane angle patients (29.6% vs 11.3%). Based on the articles about complications, patients who underwent MDO showed a lower incidence of persistent inferior alveolar nerve disturbance (2.9%) and condylar resorption (1.4%) compared with BSSO patients, in whom the incidence of these conditions was 27.8% and 6.1%, respectively. CONCLUSION: Both BSSO and MDO showed similar relapse rates for mandibular advancements between 6 and 10 mm. Both techniques may also share similar risk factors for skeletal relapse. BSSO has a higher incidence of persistent neurosensory disturbances and condylar resorption than MDO. Randomized controlled trials of these 2 techniques are still lacking.
Authors: Lukas B Seifert; Christopher Langhans; Yakub Berdan; Sophie Zorn; Michelle Klos; Constantin Landes; Robert Sader Journal: Oral Maxillofac Surg Date: 2022-05-20