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Surgical cutting guide and single plate fixation for intraoral vertical ramus osteotomy

  • Y. Zhang
    Affiliations
    Discipline of Oral and Maxillofacial Surgery, National University Centre for Oral Health Singapore, Singapore

    Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Level 10, Dean’s Office, National University of Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore 119085, Singapore
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  • C.W. Yong
    Affiliations
    Discipline of Oral and Maxillofacial Surgery, National University Centre for Oral Health Singapore, Singapore

    Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Level 10, Dean’s Office, National University of Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore 119085, Singapore
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  • R.S.K. Lim
    Affiliations
    Digital Dentistry Unit, National University Centre for Oral Health Singapore, Singapore
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  • A.A.T. Lim
    Correspondence
    Corresponding author at: Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Level 10, Dean’s Office, National University of Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore 119085, Singapore.
    Affiliations
    Discipline of Oral and Maxillofacial Surgery, National University Centre for Oral Health Singapore, Singapore

    Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Level 10, Dean’s Office, National University of Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore 119085, Singapore
    Search for articles by this author
Published:November 18, 2022DOI:https://doi.org/10.1016/j.ijom.2022.11.003

      Abstract

      With the advancement of digital technology over the last few decades, the use of virtual surgical planning and fabrication of surgical guides have tremendously improved the outcomes of various maxillofacial surgical procedures. The intraoral vertical ramus osteotomy (IVRO) is an orthognathic surgical procedure largely employed for mandibular setback in correcting dentofacial deformities. This study describes the design and application of a surgical cutting guide for IVRO. The guide can also be used to facilitate the placement of miniplate fixation. The initial experience at the authors’ centre suggests that the guide has allowed the osteotomy to be performed with increased precision and confidence. Furthermore, the use of miniplate fixation decreased the period of maxillomandibular fixation. However, a larger series is required to evaluate the utility of this system more thoroughly.

      Keywords

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      References

        • McKenna S.J.
        • King E.E.
        Intraoral vertical ramus osteotomy procedure and technique.
        Atlas Oral Maxillofac Surg Clin N Am. 2016; 24: 37-43
        • Choi Y.S.
        • Yun K.I.
        • Kim S.G.
        Long-term results of different condylotomy designs for the management of temporomandibular joint disorders.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 132-137
        • Chen H.S.
        • Chen Y.S.
        • Lin I.L.
        • Chen C.F.
        Antilingula as a surgical reference point for vertical ramus osteotomy.
        Biomed Res Int. 2021; 20215585297
        • Loh L.H.J.
        • Sesanto R.L.
        • Catlin K.A.
        • Oster R.A.
        • Louis P.J.
        Does the Levasseur–Merrill retractor provide reliable in vivo guidance for the intraoral vertical ramus osteotomy?.
        J Oral Maxillofac Surg. 2022; https://doi.org/10.1016/j.joms.2022.08.002
        • Yates C.
        • Olson D.
        • Guralnick W.
        The antilingula as an anatomic landmark in oral surgery.
        Oral Surg Oral Med Oral Pathol. 1976; 41: 705-708
        • Park K.R.
        • Kim S.Y.
        • Kim G.J.
        • Park H.S.
        • Jung Y.S.
        Anatomic study to determine a safe surgical reference point for mandibular ramus osteotomy.
        J Craniomaxillofac Surg. 2014; 42: 22-27
        • Chen C.M.
        • Hsu H.J.
        • Liang S.W.
        • Chen P.H.
        • Hsu K.J.
        • Tseng Y.C.
        Two-thirds anteroposterior ramus length is the preferred osteotomy point for intraoral vertical ramus osteotomy.
        Clin Oral Investig. 2022; 26: 1229-1239
        • Peleg O.
        • Mahmoud R.
        • Shuster A.
        • Arbel S.
        • Kleinman S.
        • Mijiritsky E.
        • Ianculovici C.
        Vertical ramus osteotomy, is it still a valid tool in orthognathic surgery?.
        Int J Environ Res Public Health. 2022; 1910171
        • Chen C.M.
        • Lai S.S.
        • Wang C.H.
        • Wu J.H.
        • Lee K.T.
        • Lee H.E.
        The stability of intraoral vertical ramus osteotomy and factors related to skeletal relapse.
        Aesthetic Plast Surg. 2011; 35: 192-197
        • Chen C.M.
        • Hwang D.S.
        • Hsiao S.Y.
        • Chen H.S.
        • Hsu K.J.
        Skeletal stability after mandibular setback via sagittal split ramus osteotomy verse intraoral vertical ramus osteotomy: a systematic review.
        J Clin Med. 2021; 104950
        • Kim J.
        • Park J.
        • Jung H.
        • Jung Y.
        Safety and stability of postponed maxillomandibular fixation after intraoral vertical ramus osteotomy.
        J Craniofac Surg. 2018; 29: 2226-2230
        • Glineburg R.W.
        • Laskin D.M.
        • Blaustein D.I.
        The effects of immobilization on the primate temporomandibular joint: a histologic and histochemical study.
        J Oral Maxillofac Surg. 1982; 40: 3-8
        • Monson L.A.
        Bilateral sagittal split osteotomy.
        Semin Plast Surg. 2013; 27: 145-148
        • Li D.T.S.
        • Wang R.
        • Wong N.S.M.
        • Leung Y.Y.
        Postoperative stability of two common ramus osteotomy procedures for the correction of mandibular prognathism: a randomized controlled trial.
        J Craniomaxillofac Surg. 2022; 50: 32-39
        • Will L.
        • West R.
        Factors influencing the stability of the sagittal split osteotomy for mandibular advancement.
        J Oral Maxillofac Surg. 1989; 47: 813-818
        • Al-Moraissi E.A.
        • Ellis 3rd, E.
        Is there a difference in stability or neurosensory function between bilateral sagittal split ramus osteotomy and intraoral vertical ramus osteotomy for mandibular setback?.
        J Oral Maxillofac Surg. 2015; 73: 1360-1371
        • Troulis M.J.
        • Kaban L.B.
        Endoscopic vertical ramus osteotomy: early clinical results.
        J Oral Maxillofac Surg. 2004; 62: 824-828
        • Islam I.
        • Lim A.A.T.
        • Wong R.C.W.
        Changes in bite force after orthognathic surgical correction of mandibular prognathism: a systematic review.
        Int J Oral Maxillofac Surg. 2017; 46: 746-755
        • Chew M.T.
        Spectrum and management of dentofacial deformities in a multiethnic Asian population.
        Angle Orthod. 2006; 76: 806-809
        • Park J.C.
        • Lee J.
        • Lim H.J.
        • Kim B.C.
        Rotation tendency of the posteriorly displaced proximal segment after vertical ramus osteotomy.
        J Craniomaxillofac Surg. 2018; 46: 2096-2102
        • Yamauchi K.
        • Takenobu T.
        • Takahashi T.
        Condylar luxation following bilateral intraoral vertical ramus osteotomy.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104: 747-751
        • Tabrizi R.
        • Sarrafzadeh A.
        • Shafiei S.
        • Moslemi H.
        • Dastgir R.
        Does maxillomandibular fixation affect skeletal stability following mandibular advancement? A single-blind clinical trial.
        Maxillofac Plast Reconstr Surg. 2022; 4419