Early screw removal for correction of occlusal discrepancies following rigid internal fixation in orthognathic surgery.

Occlusal discrepancies that occur after orthognathic surgery in which rigid internal fixation was used are technically difficult to correct. These discrepancies often lead to prolonged postoperative orthodontics and possibly to compromised results. The effectiveness of the removal of rigid internal fixation in correcting these changes was studied retrospectively. Of 169 patients who underwent bilateral sagittal osteotomies of the mandible, 13 developed postoperative malocclusions, and their rigid internal fixation was removed (an average of 21 days postoperatively). Occlusion was improved in 11 of the patients. In the two patients who showed no improvement in occlusion, fixation had been removed at 5 weeks in one and at 6 weeks in the other. One patient had a slight relapse 6 months postoperatively. All other patients had stable occlusions and experienced no complications. Recommendations for use of the technique and potential complications are discussed.