Rigid versus wire fixation for mandibular advancement: skeletal and dental changes after 5 years. 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] Journal article

Title	Rigid versus wire fixation for mandibular advancement: skeletal and dental changes after 5 years.
Author(s)	Dolce C, Hatch JP, Van Sickels JE, Rugh JD
Institution	Department of Orthodontics, University of Florida, Gainesville, USA. cdolce@dental.ufl.edu
Source	Am J Orthod Dentofacial Orthop 2002 Jun; 121(6):610-9.
MeSH	Adolescent Adult Analysis of Variance Bone Screws Bone Wires Cephalometry Chi-Square Distribution Chin Comparative Study Female Follow-Up Studies Humans Immobilization Incisor Jaw Fixation Techniques Male Malocclusion, Angle Class II Mandible Mandibular Advancement Prospective Studies Recurrence Research Support, U.S. Gov't, P.H.S. Retrognathism Treatment Outcome
Abstract	The bilateral sagittal split osteotomy (BSSO) is the most common surgical procedure for the correction of mandibular retrognathism. Commonly, the proximal and distal segments are fixated together with either wire or rigid screws or plates. The purpose of this study was to compare long-term (5 years) skeletal and dental changes between wire and rigid fixation after BSSO. In this multisite, prospective, randomized clinical trial, the rigid fixation group received three 2-mm bicortical position screws, and the wire fixation group received inferior border wires and 6 weeks of skeletal maxillomandibular fixation with 24-gauge wires. Cephalometric films were obtained 2 weeks before surgery and at 1 week, 8 weeks, 6 months, 1 year, 2 years, and 5 years after surgery. Linear cephalometric changes were referenced to a cranial base coordinate system. Before surgery, both groups were comparable with respect to linear and angular measurements of craniofacial morphology. Both groups underwent similar surgical changes. Skeletal and dental movements occurred in both groups throughout the study period. Five years after surgery, the wire group had 2.2 mm (42%) of sagittal skeletal relapse, while the rigid group remained unchanged from immediately postsurgery. Surprisingly, at 5 years, both groups had similar changes in overbite and overjet. This was attributed to dental changes in the maxillary and mandibular incisors. Although rigid fixation is more stable than wire fixation for maintaining the skeletal advancement after a BSSO, the incisor changes made the resultant occlusions of the 2 groups indistinguishable.
Language	eng
Pub Type(s)	Clinical Trial Journal Article Multicenter Study Randomized Controlled Trial
PubMed ID	12080314

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