Alteration of the mandibular plane during sagittal split advancement: Short- and long-term stability

Objectives: We investigated predictors of long- and short-term stability of surgical mandibular advancements with bilateral sagittal split osteotomy (BSSO). Study design: Class II patients (n = 127) received mandibular advancement through BSSO with either rigid internal fixation or wire osteosynthesis. We used multiple linear regression analysis to assess the association of predictor variables with post-treatment horizontal and vertical B-point movement through 2 years. Results: Counterclockwise rotation of the mandibular plane angulation (MPA) was associated with greater horizontal and vertical relapse at all time periods except 8 weeks. Wire osteosynthesis, larger advancements, younger age, and genioplasty were significantly associated with relapse. Conclusions: Surgically closing the MPA is associated with late horizontal and vertical relapse, whereas fixation type is related to early B-point movement. Large advancements with forward and upward repositioning of the mandible, genioplasty, and young age also play a role in relapse after BSSO.