Long-term stability of anterior open-bite closure with bilateral sagittal split osteotomy.

Abstract

INTRODUCTION:

Maxillary impaction and bimaxillary osteotomies are used to treat anterior open-bite malocclusions but can have adverse soft-tissue effects. Correcting an anterior open bite with a single mandibular procedure avoids these undesirable soft-tissue effects, but the stability of this procedure is unknown. The purpose of this study was to assess the long-term stability of anterior open-bite correction with bilateral sagittal split osteotomy and rigid internal fixation.

METHODS:

Orthognathic surgical records of 1 oral surgeon were searched for all patients treated for anterior open bite with bilateral sagittal split osteotomy and surgical closing rotation of the mandible with rigid internal fixation. Cephalometric films from initial consultation, presurgery, postsurgery, orthodontic appliance removal, and a mean of 4.5 years after orthodontic appliance removal were collected, traced, and measured.

RESULTS:

Thirty-one patients fit the inclusion criteria for this study and had an initial mean open bite of -2.6 mm (SD, 1.1 mm). The patients experienced an average mandibular closing rotation of 3.7° (SD, 2.4°) with surgery. By orthodontic appliance removal, the mandible rotated open 1.1°, and incisor overlap was 1.4 mm (SD, 1.0 mm). Approximately 4.5 years after orthodontic appliance removal, the mean incisor overlap was maintained at 1.0 mm (SD, 1.0 mm), yet the mandible rotated open an additional 1.1°. Only 3 patients relapsed to no incisor overlap in the long term, and only 3 patients experienced relapse greater than 1 mm in the long term.

CONCLUSIONS:

Approximately 90% of the treated patients had a positive incisor overlap 4.5 years after orthodontic appliance removal. Despite a 60% loss of mandibular surgical closing rotation, only 10% of the patients relapsed to no incisor overlap in the long term. Bilateral sagittal split osteotomy and surgical closing rotation of the mandible by using rigid internal fixation should be considered a stable alternative in the treatment of mild-to-moderate anterior open-bite malocclusions.

• Authors: Adelina M Fontes, Donald R Joondeph, Dale S Bloomquist, Geoffrey M Greenlee, Terry R Wallen, Greg J Huang
• Journal: American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (Am J Orthod Dentofacial Orthop) Vol. 142 Issue 6 Pg. 792-800 (Dec 2012) ISSN: 1097-6752 [Electronic] United States
• PMID: 23195365 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Topics

• Adult
• Cephalometry
• Female
• Genioplasty
• Humans
• Male
• Middle Aged
• Open Bite (prevention & control, surgery)
• Osteotomy, Sagittal Split Ramus
• Secondary Prevention