Positional change of the hyoid bone after bilateral sagittal split osteotomy with rigid and wire fixation

The purpose of this study was to compare positional changes of the hyoid bone and the amount of postsurgical compensation in mandibular position in patients who received either wire or rigid fixation after surgery. Data were analyzed from 97 patients (25 males and 72 females) who were randomized to receive wire (43) or rigid (54) fixation after mandibular advancement surgery as part of a multicenter clinical trial. Radiographs were digitized before surgery (T2), immediately after surgery (T3), and 8 weeks (T4), 6 months (T5), 1 year (T6), and 2 years (T7) after surgery. The wire group had greater sagittal relapse of the hyoid bone at T6 (P = .007), which persisted at T7 (P = .02). Both groups showed upward movement of the hyoid bone after surgery. There was no relationship between the vertical change in the the hyoid bone position and the vertical position of mandible (B point y coordinate, mandibular plane). However, there was a relationship between the horizontal hyoid bone position and B point during the postsurgical period (rigid, r = 0.450; wire, r = 0.517). The direct distance from the hyoid bone to basion increased (P < .001) in both groups at T3 and then recovered its original length after 8 weeks (P < .001). The rigid group showed no significant change in distance from the hyoid to the genial tubercles, but the wire group showed recovery of the muscle length at T6 (P < .05) and T7 (P < .05).