A comparative study of wire osteosynthesis versus bone screws in the treatment of mandibular prognathism.

In sagittal split osteotomies as well as in vertical osteotomies for reduction of the mandible, wire and bone screw osteosynthesis has been used in the Department of Oral and Maxillofacial Surgery of the University of Erlangen-Nuremberg within the last few years in a total of 221 cases of mandibular prognathism. In about one half of these cases a conventional wire osteosynthesis was performed, and in the other half a stable osteosynthesis with bone screws was used. One hundred twenty-one cases could be included in a follow-up study, and a true comparison could be made between the two methods. The results of our study were quite interesting: There were no signs of an increase in temporomandibular joint problems when the bone screw technique was used. However, slightly more alterations in the mandibular nerve were found. The relapse tendency, on the other hand, was minimal in cases in which bone screws were applied, in comparison with those in which wire osteosynthesis was used.