Document Detail

Modification of the sagittal split osteotomy of the mandibular ramus: mobilizing vertical osteotomy of the internal ramus segment.
MedLine Citation:
PMID:  19615584     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We describe a new surgical procedure to improve stability when counterclockwise rotation of the maxillomandibular complex and the occlusal plane is intended. PATIENTS AND METHODS: This preliminary prospective study evaluated 10 patients (8 female patients and 2 male patients) who each underwent maxillomandibular surgical advancement with counterclockwise rotation of the occlusal plane. A mandibular counterclockwise rotation was done in all cases with bilateral ramus sagittal split osteotomy. After the split of the ramus had been completed, a vertical osteotomy was done distally to the second molar on the internal ramus segment. With the completion of this vertical osteotomy, the internal ramus segment became completely mobile. All osteotomies were stabilized with rigid internal fixation by use of plates with monocortical screws. RESULTS: Ten patients have been treated with the "mobilizing vertical osteotomy of the internal ramus segment." The mean reduction of the occlusal plane angle was 10.1 degrees , showing a substantial counterclockwise rotation of the maxillomandibular complex. All patients had significant improvement of their facial balance. After a 1-year follow-up period, all cases but 1 showed very good stability of their occlusion and occlusal plane angle. An 11.4% relapse of the forward movement of the mandible was noted. CONCLUSIONS: On the basis of this prospective study, we conclude that when performing a counterclockwise rotation of the maxillomandibular complex, the mobilizing vertical osteotomy of the internal ramus segment combined with the sagittal split osteotomy of the mandible potentially enhances the occlusal plane angle and occlusal stability after a 1-year period.
Daniel Ricard; Joël Ferri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  67     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1691-9     Citation Subset:  AIM; D; IM    
Chief of Service, Oral and Maxillofacial Surgery, Centre de santé et de services sociaux de Gatineau (Hull Hospital), Gatineau, Quebec, Canada.
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MeSH Terms
Bone Plates
Bone Screws
Dental Arch / surgery
Dental Occlusion
Follow-Up Studies
Longitudinal Studies
Malocclusion / surgery*
Mandible / surgery*
Mandibular Advancement / instrumentation,  methods
Maxilla / surgery
Open Bite / surgery
Osteotomy / classification,  instrumentation,  methods*
Osteotomy, Le Fort / methods
Prospective Studies
Tongue Habits
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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