Evaluation of Condylar Position and Mandibular Stability following Sagittal Split Ramus Osteotomy

Comparison of PLLA Screw, Titanium Screw and Wire in Bone Fixation

Abstract

In this study, to investigate the involvement of changes in the condylar position on mandibular stability after a sagittal split ramus osteotomy (SSRO) for mandibular prognathism, the condylar position and mandibular movement in 32 patients who underwent SSRO were radiographically examined using standard tomographs and lateral cephalometric radiographs. Subjects were separated into three groups: 8 patients who received titanium fixation, 9 patients who received poly-L-lactic acid (PLLA) fixation, and 15 patients who received wire fixation. Cephalometric analysis was evaluated preoperatively (T1), immediately after surgery (T2), and at one year after surgery (T3). Changes in condylar position were determined using tomographs at the times of T1 and T3, measuring on the right and left sides independently. The results of cephalometric analysis showed that a significant forward movement of mandible (point B) at the time of T3 was observed in the wire fixation group compared with the PLLA and titanium fixation groups, while no differences in the other cephalometric variables were indicated. Regarding changes in condylar position, no significant differences were found in the three fixation groups at the times of T1 and T3, showing similar patterns of the position changes in the three fixation groups. These results suggest that mandibular stability after SSRO is not associated with changes in condylar position or method of bone fixation.