Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 11-12, Pages: 704-710
https://doi.org/10.2298/SARH1212704S
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The effects of orthognathic surgery on mandibular movements in patients with mandibular prognathism
Sinobad Vladimir (Stomatološki fakultet, Klinika za maksilofacijalnu hirurgiju, Beograd)
Dodić Slobodan (Stomatološki fakultet, Klinika za stomatološku protetiku, Beograd)
Strajnić Ljiljana (Medicinski fakultet, Klinika za stomatologiju, Novi Sad)
Vukadinović Miroslav (Stomatološki fakultet, Klinika za maksilofacijalnu hirurgiju, Beograd)
Introduction. Mandibular prognathism, one of the most severe dentofacial
deformities, affects the person’s appearance, psychological health and the
quality of life in the most sensitive age period. Objective. The aim of this
study was to evaluate the effects of sagittal split ramus osteotomy on the
range of mandibular border movements in the early postoperative period.
Methods. The study was conducted on 20 patients, of mean age 20.8 years, with
mandibular prognathism. All patients included in this study were operated on
by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal
Pont followed by mandibular immobilization during eight weeks. In all
patients mandibular border movements were recorded before and six months
after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH,
Leutkirch, Germany). Results. The analysis of the chosen kinematic parameters
revealed that sagittal split ramus osteotomy followed by eight weeks of
mandibular immobilization had severe effects on the mouth opening. Six months
after surgery the range of maximal mouth opening decreased for approximately
13.9 mm in relation to the preoperative stage. On the contrary, the ranges of
maximal protrusion and the border of laterotrusive excursions increased
significantly after surgery. Conclusion. In patients with mandibular
prognathism where enormous mandibular growth was the main causal factor of
the deformity, the sagittal split ramus osteotomy yielded good results. The
rigid fixation of bone fragments and reduced period of mandibular
immobilization followed by appropriate physical therapy could considerably
contribute to a more rapid recovery of mandibular kinematics in the
postoperative period.
Keywords: mandibular prognathism, mandibular movements, orthognathic surgery