Three-Dimensional Analysis of Long-Term Stability After Bilateral Sagittal Split Ramus Osteotomy Fixed With a Single Miniplate With 4 Monocortical Screws and 1 Bicortical Screw: A Retrospective 2-Center Study.

PURPOSE: This study evaluated the long-term stability of bilateral sagittal split ramus osteotomy fixed with a single miniplate with 4 monocortical screws and 1 bicortical screw (hybrid technique [HT]) using 3-dimensional (3D) analysis and an objective measuring tool, cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Sixty-four patients who underwent bimaxillary surgery with mandibular advancement fixed with the HT were selected from 2 different institutions and enrolled in this retrospective study. All patients underwent CBCT preoperatively, 1 month after surgery, and 12 months after surgery. To estimate the long-term stability of the HT, volumetric comparisons were performed using the following measurements: distance between the gonion and the B point in the sagittal plane; distance between the right and left gonion transversally; and the angle of the line connecting the mandibular notch and the gonion and the line connecting the gonion and the B point vertically. RESULTS: Statistical analysis showed no relevant relapse (<1 mm or <1°) when using the HT. However, a positive correlation between the amount of advancement and the amount of postoperative relapse was observed. CONCLUSION: The HT produces stable postoperative 3D results after 12 months.

[Soft tissue management to control nasal changes after Le Fort I Osteotomy]. / Ostéotomie de Le Fort 1 : gérer les tissus mous pour contrôler les modifications du nez.

INTRODUCTION: Adverse effects in the nasolabial region should be anticipated after Le Fort I osteotomy. Intraoperative factors such as the extent of surgical dissection, type of closure and perinasal soft tissue reconstruction seem to influence soft tissue response. Attempts to control these changes have been made over the years and several techniques have been proposed. MATERIALS AND METHODS: The authors present a minimally invasive alternative surgical technique to control alar base widening as well as lip shortening.