SURGICAL-ORTHODONTIC CORRECTION OF MANDIBULAR DEFICIENCY IN GROWING CHILDREN - (LONG-TERM TREATMENT RESULTS)

Surgical correction of mandibular deficiency has traditionally been delayed until after growth completion. On the basis of available research data on facial growth in the skeletal Class II populace, and our experience with facial fractures in children, we found no scientific reason to delay surgical correction of mandibular deficiency in growing children. Six years ago we began the surgical correction of mandibular deficiency in select cases during active growth using the modified sagittal split osteotomy. Twelve actively growing children, ages 8 to 16 years were evaluated with post surgical follow up periods ranging from 2 years 2 months to 5 years 7 months. Computerized morphometric analysis were done on the cepholometric radiographs taken pre-surgically, during intermaxillary fixation, 3 months following surgery and at various other post operative intervals to assess surgical results, relapse, and subsequent facial growth. Average advancement was 5.4 mm, average relapse was less than 5% of the amount of advancement, and facial growth following surgery was harmonious in all cases. All patients received thorough long-term post-operative clinical and radiographic examinations. All twelve patients had normal incisal opening (average 45.6 mm) and good excursive and protrusive movements. There was no mental nerve dysfunction at the longest recall examination in any of the 12 patients. No pathological radiographic changes were observed in any of the temporomandibular joints. Mandibular advancements can be safely and successfully performed in actively growing patients with expected harmonious growth between the maxilla and mandible. © 1979 Georg Thieme Publishers.