Objective: To assess the usefulness of maxillo-mandibular fixation (MMF), occlusal and skeletal stabilities were evaluated after bilateral sagittal splitting ramus osteotomy (BSSRO) with or without MMF to treat mandibular prognathism or asymmetry.
Patients and Methods: Thirty-three cases who underwent surgical correction of mandibular prognathism or asymmetry were analyzed. The surgical procedure in all cases consisted of SSRO. The segments were fixed rigidly with titanium screws. A postoperative MMF was performed in 16 patients within one day of the SSRO. The MMF was placed for one week. The other 17 patients were free to move their jaw on the day of the surgery, and received occlusal guidance with elastics starting from the third postoperative day. Cephalograms were taken preoperatively, at 1 day postoperatively, and at 1, 3, 6, 12 and 24 months after surgery. Skeletal and occlusal stabilities were then assessed.
Results: Even without MMF, occlusion was guided to the planned position with soft elastics after surgery. Later than 1 month, occlusal and skeletal stability were satisfactory in both groups, and there was no correlation between the surgical results and post-operative MMF.
Conclusion: MMF may not be necessary after a rigid fixation SSRO to treat mandibular prognathism or asymmetry, considering the risks of airway problems.

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A survey was conducted on 516 cases of orthognathic surgery at Kyoto Oral Health Care Center, Rakuwakai Otowa Hospital from 2002 to 2008.
The results were as follows:
1.The total number of patients was 516 cases, approximately 40.2% of the total number of inpatients. The annual number of operations has markedly increased since 2002.
2. The male-female ratio was 1: 3.0.
3. The mean age was 25.8±7.6 years old.
4.The most predominant diagnosis was mandibular prognathism (33.9%).
5. Intraoral vertical ramus osteotomy (IVRO) only was performed in 18.2% of all cases, while sagittal split ramus osteotomy (SSRO) only was performed in 14.5%.
6. The mean operation time and blood loss in IVRO were 2 hr and 6 min and 71 g, and those in SSRO were 2 hr and 37 min and 157 g.
7. Osteosynthesis of bone fragments in SSRO was carried out with plate fixation by an intraoral system.
8. The mean duration of hospitalization was 6.7 days.
9. The introduction rate was 96.4%. The number of participating orthodontic dental clinics was 30.

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von Recklinghausen's disease (neurofibromatosis type I) is a chromosomal dominant hereditary disease, characterized by café-au-lait spots of the skin and multiple neurofibroma. Importantly, the neurofibroma arising in the oral and maxillofacial region is known to result in a jaw deformity. We report a case of facial asymmetry which may have been due to the neurofibroma of von Recklinghausen's disease and the repeated surgical intervention for it. The patient was a 20-year-old male. He had repeatedly undergone surgical extirpation of a tumor in the left parotid gland region since he was 3 years old. In the present findings, his face was asymmetric and his dental arch was narrow because of the mandibular deviation and the soft tissue mass in the left mandibular region. Radiographic examinations revealed a bone defect at the mandibular angle and atrophy of the left ramus. To improve these problems, distraction osteogenesis to expand the dental arches, and two-jaw surgery and iliac bone graft to restore the skeletal asymmetry were performed. Upon follow-up one year later, skeletal relapse was not noted.

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