Comparison of Postoperative Stability Between BSSRO and Le Fort 1 Osteotomy with BSSRO in Skeletal Class III Malocclusio
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ORIGINAL ARTICLE
Comparison of Postoperative Stability Between BSSRO and Le Fort 1 Osteotomy with BSSRO in Skeletal Class III Malocclusion with Severe Open Bite Kazuhiro Ooi1,3 • Nobuo Inoue2 • Kazuhiro Matsushita1 • Hiro-o Yamaguchi1 Tadashi Mikoya1 • Shuichi Kawashiri3 • Kanchu Tei1
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Received: 7 August 2019 / Accepted: 12 October 2019 Ó The Association of Oral and Maxillofacial Surgeons of India 2019
Abstract Introduction We aimed to investigate postoperative stability after orthognathic surgery in patients with skeletal class III malocclusion with severe open bite by comparison between bilateral sagittal splitting osteotomy (BSSRO) and BSSRO with Le Fort 1 osteotomy. Materials and methods Seventeen patients with skeletal class III malocclusion with severe open bite who were needed more than 6 degree counterclockwise rotation of distal segment by only BSSRO in preoperative cephalometric prediction. The subjects were divided into group A, where 9 patients were treated by BSSRO, and group B, where 8 patients were treated by BSSRO with Le Fort 1 osteotomy. Patient’s characteristics of age, gender, preoperative over jet (OJ) and over bite (OB) were not found to be significantly different between the two groups. Counterclockwise rotation of distal segment in preoperative cephalometric prediction by only BSSRO was not found to be significantly different between group A of 7.6 (6–10.6) degree and group B of 9 (6–13) degree. The amount of rotation was reduced to 5.4 (3–10) degree by bimaxillary surgery using BSSRO and Le Fort 1 osteotomy in group B. & Kazuhiro Ooi [email protected] 1
Oral and Maxillofacial Surgery, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7 Kita-ku, Sapporo, Hokkaido 060-8586, Japan
2
Gerodontology, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7 Kita-ku, Sapporo, Hokkaido 060-8586, Japan
3
Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
OJ and OB were measured as occlusal stability factor. Distance between ANS-to-PNS plane and the edge of upper incisor (NF–U1Ed), and distance between Menton and edge of lower incisor (Me–L1Ed) were measured as skeletal stability factor using cephalometric analysis. These lengths were measured at pre-surgery (T0), 2 weeks after surgery (T1) and 1 year after surgery (T2), and these differences between the two groups were statistically analyzed. Results OJ and OB kept a good relation at any experimental periods. The change of Me–L1Ed was significantly larger in group A (1.21 mm at T0–T1, 1.02 mm at T0–T2) than in group B (0.14 mm at T0–T1, 0.16 mm at T0–T2). The change of NF–U1Ed was not significantly different between group A (1.07 mm at T0–T1, 0.57 mm at T0–T2) and group B (0.51 mm at T0–T1, - 0.05 mm at T0–T2). Conclusion In case with more than 6 degree counterclockwise rotation of distal segment, skeletal stability wa
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