Long-term stability of anterior open-bite closure with bilateral sagittal split osteotomy

Author(s): Fontes AM, Joondeph DR, Bloomquist DS, Greenlee GM, Wallen TR, et al.

Abstract

Introduction: Maxillary impaction and bimaxillary osteotomies are used to treat anterior open-bite malocclusions but can have adverse soft-tissue effects. Correcting an anterior open bite with a single mandibular procedure avoids these undesirable soft-tissue effects, but the stability of this procedure is unknown. The purpose of this study was to assess the long-term stability of anterior open-bite correction with bilateral sagittal split osteotomy and rigid internal fixation.

Methods: Orthognathic surgical records of 1 oral surgeon were searched for all patients treated for anterior open bite with bilateral sagittal split osteotomy and surgical closing rotation of the mandible with rigid internal fixation. Cephalometric films from initial consultation, presurgery, postsurgery, orthodontic appliance removal, and a mean of 4.5 years after orthodontic appliance removal were collected, traced, and measured.

Results: Thirty-one patients fit the inclusion criteria for this study and had an initial mean open bite of -2.6 mm (SD, 1.1 mm). The patients experienced an average mandibular closing rotation of 3.7° (SD, 2.4°) with surgery. By orthodontic appliance removal, the mandible rotated open 1.1°, and incisor overlap was 1.4 mm (SD, 1.0 mm). Approximately 4.5 years after orthodontic appliance removal, the mean incisor overlap was maintained at 1.0 mm (SD, 1.0 mm), yet the mandible rotated open an additional 1.1°. Only 3 patients relapsed to no incisor overlap in the long term, and only 3 patients experienced relapse greater than 1 mm in the long term.

Conclusions: Approximately 90% of the treated patients had a positive incisor overlap 4.5 years after orthodontic appliance removal. Despite a 60% loss of mandibular surgical closing rotation, only 10% of the patients relapsed to no incisor overlap in the long term. Bilateral sagittal split osteotomy and surgical closing rotation of the mandible by using rigid internal fixation should be considered a stable alternative in the treatment of mild-to-moderate anterior open-bite malocclusions.

Similar Articles

Three-year stability of open-bite correction by 1-piece maxillary osteotomy

Author(s): Espeland L, Dowling PA, Mobarak KA, Stenvik A

Temporomandibular disorders and orthognathic surgery

Author(s): Cascone P, di Paolo C, Leonardi R, Pedullà E

Changes in temporomandibular joint dysfunction after orthognathic surgery

Author(s): Wolford LM, Reiche-Fischel O, Mehra P

The skeletal stability after maxillo-mandibular osteotomy with a “physiological positioning strategy”

Author(s): Ohba S, Nakao N, Nakatani Y, Kawasaki T, Minamizato T, et al.

Root resorption associated with orthodontic tooth movement: a systematic review

Author(s): Weltman B, Vig KW, Fields HW, Shanker S, Kaizar EE

Root damage and repair in patients with temporary skeletal anchorage devices

Author(s): Ahmed VKS, Rooban T, Krishnaswamy NR, Mani K, Kalladka G

Gummy smile and facial profile correction using miniscrew anchorage

Author(s): Kaku M, Kojima S, Sumi H, Koseki H, Abedini S, et al.

Multiloop edgewise archwire in the treatment of a patient with an anterior open bite and a long face

Author(s): Ribeiro GL, Regis S Jr, da Cunha Tde M, Sabatoski MA, Guariza-Filho O, et al.