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The International Journal of Adult Orthodontics & Orthogathic Surgery
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International Journal of Adult Orthodontics and Orthognathic Surgery

Year 1997
Volume 12 , Issue 4

Pages: 251 - 261

Postsurgical stability following correction of severe facial asymmetry


In a retrospective study of 28 patients, posteroanterior cephalometric films were used to determine changes at surgery and post-surgical stability of the correction of facial asymmetry. All patients had mandibular ramus osteotomies; 18 also had Le Fort I osteotomy, and 8 had inferior border osteotomy of the mandible. Changes in transverse and vertical coordinate positions of 14 points were determined on presurgical, immediate postsurgical, and at least 1-year follow-up posteroanterior cephalograms. Because the mandible deviated to the left in the great majority of the patients, changes at surgery were primarily repositioning of the chin to the right and leveling of the canted occlusal plane. Maxillary surgery to level the cant was quite stable, as was transverse repositi oning of the chin by inferior border osteotomy. Ramus surgery to transversely reposition the chin was less stable, with mean relapse of about one thrid the surgical movement. One third of the patients had greater than 4 mm of postsurgical change in the transverse position of the chin. Significant postsurgical changes in the gonial angles also were observed, probably related primarily to bone remodeling in this area. Two-jaw surgery was as stable as, perhaps slightly more stable than, mandibular surgery alone. Because these patients had more severe problems and more extensive surgical change than typical asymmetry patients, the results are likely not applicable to milder asymmetry.


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