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Horizontal changes in the condylar head

Oral and maxillofacial surgery Horizontal changes in the condylar head after sagittal split ramus osteotomy with bent plate fixation Koichiro Ueki DDS, PhDa, , , Kagan Degerliyurt DDSa, b, Yukari Hashiba DDSa, Kohei Marukawa DDS, PhDa, Kiyomasa Nakagawa DDS, PhDa and Etsuhide Yamamoto DDS, PhDa aDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan bDepartment of Oral and Maxillofacial Surgery, School of Dentistry, Gazi University, Ankara, Turkey Objective The purpose of this study was to evaluate the horizontal changes in the condylar head with bent plate fixation after sagittal split ramus osteotomy (SSRO) with and without a Le Fort I osteotomy. Study design Of 47 Japanese patients with mandibular prognathism, 24 underwent SSRO and 23 underwent SSRO in combination with a Le Fort I osteotomy. A 35-mm gap was made between the proximal and distal segments, and a bent plate was fixed with 4 screws in each side of the mandible. The angle of the condylar long axis, as well as the anteroposterior and mediolateral displacement of the condylar head were assessed preoperatively and postoperatively by computerized tomography (CT). Results There was no significant difference in reduction in mandibular length between SSRO alone and SSRO with Le Fort I on the axial view of a 3-dimensional CT. There were no significant differences between pre- and postoperative horizontal changes in the condylar long axis or in the anteroposterior and mediolateral displacement of the condylar head, although the length of the proximal segment in SSRO with Le Fort I osteotomy was significantly shorter than in SSRO alone (P < .05). Conclusion These results suggest that the use of a bent plate for SSRO does not change preoperative angle or position significantly in setback surgery, regardless of the addition of Le Fort I osteotomy.

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