A comparison of skeletal and dental changes between rigid and wire fixation for bilateral sagittal split osteotomy

For two years, this multisite prospective clinical trial examined longitudinal skeletal and dental changes after bilateral sagittal split osteotomy for mandibular advancement in which either rigid or wire fixation was used. Subjects in the rigid fixation group (n = 78) received 2-mm bicortical position screws, while the subjects in the wire fixation group (n = 49) received inferior border wires. Skeletal and dental changes were measured from cephalometric films taken immediately before surgery, one week after surgery, and at eight weeks, six months, one year, and two years after surgery. In both groups, the overbite and overjet increase with time, but were not different from each other. The B-point in the wire group progressively moved posteriorly, and at two years, it had relapsed 28%. In the rigid fixation group, there was a transient anterior movement of the B-point during the first six months and by two years after surgery, the B-point was unchanged from immediate post surgery. Dental changes occurred in both groups. These changes, however, were not able to accommodate the skeletal changes, resulting in similar increases in both overbite and overjet in both groups of patients. These results have implications for the orthodontists in management of the postmandibular advancement occlusion.