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Safety and Stability of Postponed Maxillomandibular Fixation After Intraoral Vertical Ramus Osteotomy

 Kim, Jun-Young  ;  Park, Jin Hoo  ;  Jung, Hwi-Dong  ;  Jung, Young-Soo 
 Journal of Craniofacial Surgery, Vol.29(8) : 2226-2230, 2018 
Journal Title
 Journal of Craniofacial Surgery 
Issue Date
Adolescent ; Adult ; Dyspnea/etiology ; Female ; Follow-Up Studies ; Humans ; Jaw Fixation Techniques ; Male ; Mandible/surgery* ; Maxilla/surgery* ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus*/adverse effects ; Physical Therapy Modalities ; Postoperative Period ; Prognathism/rehabilitation ; Prognathism/surgery* ; Respiratory Insufficiency/etiology ; Retrospective Studies ; Time Factors ; Young Adult
The purpose of this study was to evaluate the postoperative safety and long-term stability of bimaxillary orthognathic patients with postponed maxillomandibular fixation (MMF) after intraoral vertical ramus osteotomy.A total of 61 patients (21 male and 40 female patients; average age [SD], 21.7 [4.7]) were enrolled. All patients underwent maxillary LeFort I osteotomy and bilateral intraoral vertical ramus osteotomy for mandibular prognathism. During the hospital stay, postoperative airway compromise was observed and patients underwent MMF with wire at the second postoperative day. Stability was evaluated by measuring the position at each period: preoperative (T0), 2-day postoperative (T1), and 1-year postoperative.Postoperative dyspnea and respiratory distress were absent in all patients. The mean number of refixations in physiotherapy was 0.62 (0.86) and the mean duration of physiotherapy was 11.6 (5.5) days. The mean amount of mandibular setback was 12.56 (5.76) mm and menton movement 0.98 (2.36) mm superiorly (T1). The mean mandibular relapse at Pog was 0.87 (1.96) mm anteriorly. Menton showed 1.11 (1.41) mm superiorly movement 1-year postoperatively (T2).Despite its many advantages, intraoral vertical ramus osteotomy requires a period of MMF which can lead to early discomfort and airway-related emergency. In this study, the physiotherapy procedure and postoperative long-term stability in the postponed MMF group were not different from those of an immediate MMF group studied previously. It therefore constitutes a viable option for oral breathers and other compromised patients.
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2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
김준영(Kim, Jun-Young) ORCID logo https://orcid.org/0000-0002-6596-6135
박진후(Park, Jin Hoo) ORCID logo https://orcid.org/0000-0003-2337-9554
정영수(Jung, Young Soo) ORCID logo https://orcid.org/0000-0001-5831-6508
정휘동(Jung, Hwi Dong) ORCID logo https://orcid.org/0000-0003-1025-8323
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