{"title":"Does maxillomandibular fixation affect skeletal stability following mandibular advancement? A single-blind clinical trial.","authors":"Reza Tabrizi, Arash Sarrafzadeh, Shervin Shafiei, Hamidreza Moslemi, Ramtin Dastgir","doi":"10.1186/s40902-022-00350-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF).</p><p><strong>Materials and methods: </strong>A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups.</p><p><strong>Results: </strong>Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively).</p><p><strong>Conclusion: </strong>According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076785/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maxillofacial Plastic and Reconstructive Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40902-022-00350-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF).
Materials and methods: A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups.
Results: Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively).
Conclusion: According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.
背景:在正颌手术中,手术效果的稳定性仍是一个重要问题。本研究旨在评估下颌前移术后使用/不使用上颌下颌固定术(MMF)的复发率:对下颌后突患者进行了单盲临床试验,这些患者接受了下颌前突BSSO手术和Lefort I上颌骨上部复位手术。患者被随机分为治疗组(MMF)和对照组(无 MMF)。治疗组进行为期两周的MMF治疗;而对照组则不进行MMF治疗,术后仅使用引导弹力袜。分别在术前(T1)、术后即刻(T2)和术后一年(T3)拍摄侧位头颅片。测量 A 点和 B 点到 X 平面和 Y 平面的距离,以确定 1 年后垂直和水平方向的复发量作为主要结果。为了发现对照组和治疗组之间的结果差异,采用了独立的 t 检验:58名患者分两组接受了评估(MMF组28人,无MMF组30人)。BSSO术后下颌骨前移的幅度分别为(7.68±1.39)毫米和(7.53±1.28)毫米,两组间无显著差异(P= 0.68)。截骨后随访1年,B点的平均矢状变和垂直变(复发)在两组间有显著差异(分别为P=0.001和P=0.05):根据这项研究的结果,下颌前突BSSO术后短期MMF患者在矢状和垂直方向上的骨骼稳定性明显更强。