Mandibular Medial Osteotomy Modifications and Postoperative Stability

Condition(s) studied

Investigational drug(s) / intervention(s)

sagittal split osteotomy: Bilateral sagittal split ramus osteotomy will be performed as part of orthognathic surgery to correct the planned mandibular skeletal deformity. The mandibular ramus and body will be divided using the assigned medial osteotomy modification (Hunsuck or Posnick), followed by sagittal splitting of the mandible. The distal mandibular segment will then be repositioned according to the preoperative surgical plan and stabilized using appropriate osteosynthesis. Postoperative skeletal stability and mandibular relapse will be evaluated during the follow-up period.

Hunsuck Modification of Medial Mandibular Osteotomy: The Hunsuck modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be initiated at the lingula and extended posteriorly for a short distance, according to the Hunsuck modification. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations

Posnick Modification Group: The Posnick modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be performed according to the Posnick modification, with the osteotomy design extending posteriorly along the medial aspect of the mandibular ramus as described for this technique. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations.

Study summary

This study aims to compare the effects of the Hunsuck and Posnick modifications of medial mandibular osteotomy on postoperative skeletal stability and relapse in patients undergoing orthognathic surgery. The study will evaluate whether the choice of medial osteotomy technique influences postoperative mandibular relapse.

Eligibility

Primary outcome measure(s)

• Postoperative Skeletal Relapse — 1 year
  The primary outcome will be the amount and percentage of skeletal relapse between 1 month and 12 months after orthognathic surgery (T3-T1), assessed using three-dimensional cephalometric and skeletal measurements.

Trial sites (1)

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