Evaluation Of Sagittal Split Fix System And Bicortical Screw Fixation In Bilateral Sagittal Split Osteotomy. A Randomized Prospective Comparative Study

Abstract

Background: Relapse following sagittal split osteotomy is more common in mandible advancement surgeries. The dynamic action of masticatory muscle attached proximal to osteotomised bone plays an important role paving necessity for a rigid stable fixation.

Objective: The aim of this study is to assess the efficacy of bicortical screws and sliding plates after Bilateral Sagittal Split Osteotomy for rigid fixation of osteotomised segments.

Methods: The study included two groups (group A and group B) who underwent BSSO to correct their mandibular discrepancy. Group A consisted of (10 patients) who had osteosynthesis using Sliding Split Fix Plates (SYNTHES®, GERMANY), Group B consisted of (10 patients) who had osteosynthesis using Bi- cortical screws (BIOMET®). Skeletal relapse was assessed on 1^st month, 3^rd month, and 6th month post operatively. Series of lateral cephalogram was taken at the time of follow up and compare with pre op radiograph.  Statistical analysis for relapse was done by Mann Whitney test. The P value is 0.99 which was not significant in linear dimension.

Results: The relapse percentage assessed after one-year post surgery in Group A [patients with sliding split fix plates] along Sn-v axis was 14.42 %, and 21.5% was observed along 0-meridian. In Group B [Bicortical screws] along Sn-v axis the relapse percentage was 9.68% and 10.85% along 0-meridian.

Conclusion: Based on the interpretation of study results, the maximum intercuspation in molar region was achieved in Bicortical screw fixation when compared to sagittal split fix plates. The percentage of relapse in bicortical screw fixation is lesser when compared with sagittal split fix plates.