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The European Journal of Orthodontics 1992 14(2):117-124; doi:10.1093/ejo/14.2.117
© 1992 by European Orthodontic Society
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Skeletal stability after surgical correction of mandibular prognathism by vertical ramus osteotomy

Athanasios E. Athanasios*, Dimitrios Mavreas*, Nick Toutountzakis** and Martin Ritzau***

* Department of Orthodontics, Royal Dental College Aarhus, Denmark
** Department of Orthodontics, School of Dentistry, University of Athens Greece
*** Department of Oral & Maxillofacial Surgery, Sundsvall Hospital Sweden

Dr A. E. Athanasiou Royal Dental College Vennelyst Boulevard DK-8000 Aarhus C Denmark


   Abstract

The purpose of the study was to assess skeletal stability following combined surgical-orthodontic management of 52 adults with severe mandibular prognathism. Lateral cephalograms taken 1 week before surgery, within 1 week post-surgery and approximately 1 year after operation were studied by means of eight variables and a constructive stable reproducible reference system. The surgical procedure of choice was a bilateral vertical ramus osteotomy through an extra-oral approach. In all cases the condyles were left passively in the articular fossa and no attempt at their active repositioning was made. The patients were randomly allocated to an osteosynthesis or non-osteosynthesis group with regard to intramandibular fixation. Intermaxillary fixation lasted 6 weeks and an interocclusal wafer was used in all cases during this period. The findings of this study showed that during the post-operative period there was a trend for posterior rotation of the mandibular corpus (P<0.001). This pattern was also characterized by an increase (P<0.001) of the lower anterior face height and an improvement of the angle of convexity (P<0.001). These changes occurring in a direction so that the dentoskeletal profile became less concave, did not tend to reverse the goal of operation and cannot be considered as detrimental. No significant differences (P>0.05) were found between the groups without and with osteosynthesis.


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