Inferior Maxillary Repositioning Remains Stable 1 Year after Surgery but Entails a High Risk of Osteosynthesis Failure

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Abstract

Purpose: Inferior maxillary repositioning has continued to be among the most unstable orthognathic procedures. The overall purpose of the present study was to measure skeletal stability after inferior maxillary repositioning. Materials and Methods: We implemented a retrospective cohort study. The study cohort was derived from all orthognathic patients who had undergone treatment from January 2011 to December 2013 in Odense University Hospital. The inclusion criteria were orthognathic surgery with inferior maxillary repositioning in patients without maxillary segmentation or cleft lip/palate. The exclusion criteria were nonattendance at follow-up visits or requiring reoperation before the 1-year follow-up point. The primary predictor variable was the time from the 1-week follow-up examination to the 1-year follow-up examination. The primary outcome variable was maxillary skeletal movement. The other variables of interest were age, gender, preoperative occlusal relationship, maxillary movement obtained, and surgery type (mono- or bimaxillary procedure). Skeletal stability was measured at the centroid, anterior, and posterior nasal spines using the semiautomatic measurement technique. Skeletal stability was clinically defined as less than 2 mm of movement in any direction. The positive directions for the 3 axes were right, anterior, and superior. The data were analyzed using mixed model linear regression analysis and 1-sample t tests. Results: A total of 17 patients were included in the present study (mean age, 28 years; female gender, 35%; bimaxillary surgery, 59%). Inferior maxillary repositioning was stable with less than 0.3 mm mean skeletal movement in any direction. Only 1 patient had experienced a relapse of more than 1 mm in the posterior direction; no movement exceeded 2 mm. However, 3 patients were excluded from the present analysis, because they had required reoperation during the first year after surgery for osteosynthesis failure. Conclusions: Inferior maxillary repositioning was stable during the first year after surgery; however, the complication rate was high (15%). Thus, this procedure might still benefit from the use of more rigid patient-specific printed plates to increase postoperative stability.

Original languageEnglish
JournalJournal of Oral and Maxillofacial Surgery
Volume78
Issue number1
Pages (from-to)118-126
ISSN0278-2391
DOIs
Publication statusPublished - Jan 2020

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