Variation of plate fixation for mandibular advancement with intraoral vertical ramus osteotomy using endoscopically assisted intraoral rigid or semi-rigid internal fixation: Case series study: Postoperative condylar seating control for mandibular advancement.

The purpose of the present study was to evaluate the safety and efficacy associated with mandibular advancement by intraoral vertical ramus osteotomy (IVRO) with endoscopically assisted intraoral rigid or semi-rigid internal fixation. The study sample included all patients who had undergone an mandibular advancement by IVRO procedure with endoscopically assisted intraoral plate fixation from September 2008 to May 2012. An mandibular advancement by IVRO with endoscopically assisted intraoral rigid or semi-rigid internal fixation was used for mandibular advancement. The patients were analyzed prospectively, with more than 2 years of follow-up, and were evaluated in terms of functional results, postoperative complications, and skeletal stability. A total of 14 patients (bilateral, 7 patients with class II; unilateral, 7 patients with asymmetry) were included in the present study. The average degree of mandibular advancement was 5.5 ± 1.9 mm (range, 3-9 mm). Both the occlusal relationship and facial appearance in all patients were significantly improved by the surgical-orthodontic treatment, with no major harmful clinical symptoms. In addition, one-screw semi-rigid fixation could control postoperative passive condylar seating. This study showed that mandibular advancement by IVRO with endoscopically assisted, intraoral semi-rigid internal fixation offers a promising treatment alternative for patients with skeletal class II malocclusion or facial asymmetry.