Effect of stabilization of a bilateral sagittal split on orthodontic finishing after mandibular setback: A case for bicortical fixation

Purpose: This report reviews the diagnosis and management of patients with Class III skeletal patterns and discusses the stability of a bilateral sagittal split to set back the mandible using 2 fixed bicortical screws and a monocortical plate. Materials and Methods: The database of the University of Kentucky was searched for code 524.02 of the International Classification of Diseases, Ninth Revision and 21,196 cases from 2006 through 2010. Of these, cases with large anterior posterior discrepancies were identified that required maxillary advancement and mandibular setback. Two representative cases were chosen to illustrate the stability of the mandibular setback. Results: The 2 patients had good esthetic results and were debanded before their 6-month postoperative appointment. The case in which the mandible was set back the least showed the greatest skeletal stability. Conclusions: Patients with Class III occlusal patterns often have maxillary and mandibular skeletal components to their malocclusions. A bilateral sagittal split that is rigidly fixed with 2 bicortical screws and a monocortical plate will produce excellent occlusal and skeletal results when the 2 components of the deformity are addressed.