Clinical oral investigations · 2025
Evaluating a modified proximal segment manipulation technique in sagittal split osteotomy for correcting facial asymmetry: outcomes and risk factors for Menton horizontal relapse.
СтатьяНазвание и аннотация: Перевод в очереди
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Vu Viet Duc, Takahara Namiaki, Iwasaki Takuya, Kurasawa Yasuhiro, Tomomatsu Nobuyoshi, Yoda Tetsuya
Аннотация
OBJECTIVES: To evaluate the effectiveness and stability of a modified overlap method for manipulating proximal segments (PSs) during bilateral sagittal split osteotomy for correcting facial asymmetry and to identify risk factors contributing to Menton horizontal relapse.
MATERIALS AND METHODS: This retrospective cohort study involved 62 consecutive adults with class III asymmetry who underwent bimaxillary surgery. Patients were classified in two groups according to surgical techniques: the overlap group (n = 31), in which the non-deviated PS was flared outward before aligning with the distal segment (DS), and the conventional group (n = 31), in which the PSs and DS were aligned in maximum contact. Computed tomographic scans were taken before surgery (T0), postoperative 1 week (T1) and 1 year (T2). Transverse ramus measurements and maxillo-mandibular segments movements were intergrouply compared. Correlations of Menton horizontal relapse with preoperative and intraoperative factors were also assessed.
RESULTS: From T1-T0, the overlap group showed greater reductions in discrepancies for gonial width (4.09 ± 3.49 mm) and coronal ramus angle (3.67° ± 3.44°) compared to the conventional group (1.76 ± 2.55 mm; 1.70° ± 3.16°) (p = 0.004, 0.023). From T2-T1, relapses in both groups were ≤ 2 mm and ≤ 2°. No correlation was found between surgical techniques and Menton horizontal relapse.
CONCLUSIONS: The overlap method demonstrates effectiveness in correcting facial asymmetry, resulting in greater reductions in ramus discrepancies while maintaining mandibular stability one year postoperatively.
CLINICAL RELEVANCE: For severe facial asymmetry, clinicians may consider using the overlap technique to enhance postoperative facial appearance.
MATERIALS AND METHODS: This retrospective cohort study involved 62 consecutive adults with class III asymmetry who underwent bimaxillary surgery. Patients were classified in two groups according to surgical techniques: the overlap group (n = 31), in which the non-deviated PS was flared outward before aligning with the distal segment (DS), and the conventional group (n = 31), in which the PSs and DS were aligned in maximum contact. Computed tomographic scans were taken before surgery (T0), postoperative 1 week (T1) and 1 year (T2). Transverse ramus measurements and maxillo-mandibular segments movements were intergrouply compared. Correlations of Menton horizontal relapse with preoperative and intraoperative factors were also assessed.
RESULTS: From T1-T0, the overlap group showed greater reductions in discrepancies for gonial width (4.09 ± 3.49 mm) and coronal ramus angle (3.67° ± 3.44°) compared to the conventional group (1.76 ± 2.55 mm; 1.70° ± 3.16°) (p = 0.004, 0.023). From T2-T1, relapses in both groups were ≤ 2 mm and ≤ 2°. No correlation was found between surgical techniques and Menton horizontal relapse.
CONCLUSIONS: The overlap method demonstrates effectiveness in correcting facial asymmetry, resulting in greater reductions in ramus discrepancies while maintaining mandibular stability one year postoperatively.
CLINICAL RELEVANCE: For severe facial asymmetry, clinicians may consider using the overlap technique to enhance postoperative facial appearance.