Skeletal stability after mandibular advancement with rigid versus wire fixation

Calogero Dolce, Joseph E. Van Sickels, Robert A. Bays, John D. Rugh

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Purpose: This study examined the stability of skeletal changes after mandibular advancement surgery with rigid or wire fixation up to 2 years postoperatively. Patients and Methods: Subjects for this multisite, prospective, clinical trial received rigid (n = 78) or wire (n = 49) fixation. The rigid cases were fixed with three 2-mm bicortical position screws and 1 to 2 weeks of skeletal maxillomandibular fixation with elastics, and the wire fixation subjects were fixed with inferior border wires and had 6 weeks of skeletal maxillomandibular fixation with 24-gauge wires. Cephalometric radiographs were obtained before orthodontics, immediately before surgery, and at 1 week, 8 weeks, 6 months, 1 year, and 2 years after surgery. Linear cephalometric changes were referenced to a cranial base coordinate system. Results: Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean anterior sagittal advancement of the mandibular symphysis was 4.92 ± 3.01 mm in the rigid group and 5.11 ± 3.09 mm in the wire group, and the inferior vertical displacement was 3.37 ± 2.44 in the rigid group and 2.85 ± 1.78 in the wire group. The vertical changes were similar in both groups. Two years postsurgery, the wire group had 30% sagittal relapse of the mandibular symphysis, whereas there was no change in the rigid group (P <.001). Both groups experienced changes in the orientation and configuration of the mandible. Conclusions: Rigid fixation is a more stable method than wire fixation for maintaining mandibular advancement after sagittal split ramus osteotomy. (C) 2000 American Association of Oral and Maxillofacial Surgeons.

Original languageEnglish
Pages (from-to)1219-1227
Number of pages9
JournalJournal of Oral and Maxillofacial Surgery
Issue number11
StatePublished - 2000

Bibliographical note

Funding Information:
Supported by the National Institute of Health/National Institute of Dental Research Grant DE09630 to J.D.R.

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology


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