The purpose of this study was to evaluate the postoperative safety and long-term stability of bimaxillary orthognathic patients with postponed maxillomandibular fixation (MMF) after intraoral vertical ramus osteotomy. A total of 61 patients (21 male and 40 female patients; average age [SD], 21.7 [4.7]) were enrolled. All patients underwent maxillary LeFort I osteotomy and bilateral intraoral vertical ramus osteotomy for mandibular prognathism. During the hospital stay, postoperative airway compromise was observed and patients underwent MMF with wire at the second postoperative day. Stability was evaluated by measuring the position at each period: preoperative (T0), 2-day postoperative (T1), and 1-year postoperative. Postoperative dyspnea and respiratory distress were absent in all patients. The mean number of refixations in physiotherapy was 0.62 (0.86) and the mean duration of physiotherapy was 11.6 (5.5) days. The mean amount of mandibular setback was 12.56 (5.76) mm and menton movement 0.98 (2.36) mm superiorly (T1). The mean mandibular relapse at Pog was 0.87 (1.96) mm anteriorly. Menton showed 1.11 (1.41) mm superiorly movement 1-year postoperatively (T2). Despite its many advantages, intraoral vertical ramus osteotomy requires a period of MMF which can lead to early discomfort and airway-related emergency. In this study, the physiotherapy procedure and postoperative long-term stability in the postponed MMF group were not different from those of an immediate MMF group studied previously. It therefore constitutes a viable option for oral breathers and other compromised patients.
Bibliographical noteFunding Information:
From the Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea. Received May 23, 2018. Accepted for publication August 8, 2018. Address correspondence and reprint requests to Young-Soo Jung, DDS, PhD, Yonsei University College of Dentistry, Seoul, Republic of Korea; E-mail: email@example.com This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (NRF-2012R1A1A2006034). The authors report no conflicts of interest. Copyright © 2018 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000005025
© 2018 by Mutaz B. Habal, MD
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