Relationship between Frontal Gap and Postoperative Stability in the Treatment of Mandibular Prognathism

Abstract

Objectives. To investigate the correlation between frontal gaps and skeletal stability after intraoral vertical ramus osteotomy (IVRO) for correction of mandibular prognathism.Materials and Methods. Thirty-three patients with frontal gaps after IVRO-based mandibular prognathism correction were included. Three lateral and frontal cephalometric radiographs were obtained: preoperatively (T1), immediately postoperatively (T2), and 2 years postoperatively (T3). Two linear measurements (menton [Me] and frontal gap) were compared from T1 to T3 (T21: immediate surgical changes; T32: postoperative stability; T31: 2-year surgical change). Data were analyzed using Pearson’s correlation coefficient and multiple linear regression.Results. The T21 mean surgical horizontal change in the Me position was12.4±4.23 mm. Vertically, the mean downward Me movement was0.6±1.73 mm. The mean frontal gaps were4.7±2.68 mm and4±2.48 mm in the right and left gonial regions, respectively. Postoperative stability (T32) significantly correlated with the amount of setback. Frontal gaps did not have a significant effect on postoperative stability. However, multiple regression model (R2=0.341,P=0.017) showed value predictability, especially in the amount of setback.Conclusion. Frontal gaps occur after IVRO but have no significant effect on long-term postoperative skeletal stability. The primary risk factor for postoperative relapse remains the amount of mandibular setback.