Intraoral Vertical Ramus Osteotomy for Correction of Mandibular Deformity

Statement of the problem : Complication after Extraoral Vertical and Intraoral Oblique Osteotomy have been reported but in a comprehensive manner.  Although intuitively the profile of complications after Intra Oral Vertical Ramus Osteotomy (IVRO) would be similar to subcondylar osteotomy, the technique of the two procedures are different, and thus unfavorable outcome after surgery also may differ.  The aim of this study was evaluate the morbidity and complications following  correcton of mandibular deformity by IVRO.

Material and Method : A prospective study was undertaken of 271 consecutively treated orthognathic surgical patients with mandibular deformity(without mandibular deficiency). Each patients was treated by bilateral IVRO with 2 Weeks of maxillo-mandibular fixation and no interosseous fixation of proximal segment.

Method of Data Analysis :Postoperative stability ,immediately after surgery ,at 6 months , and at 12 months after surgery were made. Complications consist of vascular complications, nerve injury, infection, condylar luxation and bone hearing were assessed by retrospective individual chart review.

Results : The mean blood loss was 47g and no severe bleeding during operation. There was no wound infection and avascular necrosis after surgery. Inferior alveolar nerve neurosensory disturbance remained 2 operative sites but was not permanent.

Malocclusion after surgery was manifest by either relapse or anterior open bite  occurred in 3 patients.  Condylar dislocation occurred 1 patient.

Conclusion : Our studies indicated that surgical correction of mandibular deformity by IVRO had a beneficial effect not only on occlusion but also upon complication after surgery.

Reference:

McKenna SJ,et al: Long-term follow-up of modified condylotomy for internal derangement of the temporomandibular joint. Oral Surg Otal Med Oral Pathol 81: 509,1996.

Yoshinori Yamaguchi: Intraoral Vertical Ramus Osteotomy - surgical technique-. Jpn, J. Oral Maxillofac. surg. 58:462,2012.