The functional long-term results after bilateral sagittal split osteotomy (BSSO) with and without a condylar positioning device

Purpose: The goal of this retrospective study was to examine whether utilization of condylar positioning devices in bilateral sagittal split osteotomy leads to long-term benefits for temporomandibular joint function as compared with the manual positioning technique. Patients and Methods: The joint function of 49 patients (98 joints) who underwent bilateral sagittal split osteotomy or bimaxillary osteotomy at the University Hospital of Aachen between 1993 and 2003 was analyzed by recording joint movements with axiography supported by clinical examination of the temporomandibular joint. In 10 patients out of 28 with mandibular advancement and in 10 out of 21 with mandibular setback the Luhr positioning device was used intraoperatively to reproduce the condylar position. The joints of the remaining patients were positioned manually. The received data were statistically evaluated by using unrelated t test at P =.05. Results: In mandibular advancement the manually positioned group showed significantly less signs of temporomandibular disorders, while there were slight advantages in axiographically measured joint track lengths for the patients who were operated with positioning devices. After mandibular setback surgery clinical analysis as well as axiography presented comparable results in both groups. Conclusion: The use of a positioning device did not provide a better functional outcome long term in either mandibular advancement or setback surgery. With the manual positioning technique, an at least equally good temporomandibular joint function was attained. (C) 2006 American Association of Oral and Maxillofacial Surgeons.