The stability of facial osteotomies. 2. Mandibular advancement with bicortical screw fixation.

Surgical repositioning of the dento-skeletal components of the lower third of face, combined with appropriate orthodontic treatment, can be used to improve function and aesthetics. However, the attainment of three-dimensional stability following corrective jaw surgery continues to be a major problem in the post-surgical period. This paper examines the short-term (6 week post-operative) and long-term (12 months postoperative) horizontal skeletal stability of bilateral sagittal split mandibular advancement in 15 patients. The mean horizontal advancement of the mandible was 6.1 mm. Six weeks later, a mean continued forward movement of 0.16 mm was identified. The mean relapse at long-term follow-up was 0.46 mm (7.5%). Results indicate that rigid bicortical screw fixation of bilateral sagittal split osteotomies undertaken to correct horizontal lower dentofacial deficiency is both statistically and surgically predictable and stable when reviewed up to twelve months after surgery.