Mandibular Prognathism Clinical Trial
Official title:
Patient Satisfaction Following Vertical Ramus Osteotomy After Mandibular Setback Fixed With Patients Specific Osteosynthesis and Immediate Mobilization Versus Vertical Ramus Osteotomy Fixed With MMFin Patients With Mandibular Prognanthism
Two groups with mandibular prognanthism indicated for mandibular setback by intraoral vertical ramus osteotomy . first group will fixed with maxillomandibular fixation and the second group will fixed by customized plate
Two groups with mandibular prognanthism indicated for mandibular setback by intraoral
vertical ramus osteotomy . first group will fixed with maxillomandibular fixation and the
second group will fixed by customized plate
Interventions:
General operative procedures
Eligible patients will be randomized in equal proportions between the study group (customized
plate fixation of VRO) and the control group (maxillomandibular fixation of VRO).
Patients of Both groups will be subjected to:
1. Case history including personal data, medical, surgical history and family history
2. Clinical examination .
3. Radiographic examination in the form of cephalometric radiogragh .
4. Preoperative laboratory tests (complete blood cell count, Hemoglobin count, coagulation
profile, liver function, kidney function and blood glucose level).
5. Preoperative anesthesia assessment for fitness for general anesthesia.
vertical ramus osteotmy fixed with customized plate
- All cases will undergo one surgery under general anesthesia.
- Incision was made medial to external oblique ridge from the asendindg ramus to second
molar region
- Amucoperiosteal flap was reflected to expose the lateral mandibular ramus to the
posterior border and the sigmoid notch
- The intraoral vertical osteotomy is accomplished by using an oscillating saw to make the
cut from the sigmoid notch through the inferior border of the mandible. The osteotomy is
placed 5 mm anterior to the posterior border of the mandible to avoid injury to the
inferior alveolar neurovascular bundle
- 3D virtual planning and 3D mandible model represented fom CBCT in MIMICS
- The setback will be simulated according to pre-planned measure
- The customized bone plate is positioned to fix the proximal and distal segment together
vertical ramus osteotomy fixed with MMF.
- All cases will undergo one surgery under general anesthesia.
- incision was made medial to external oblique ridge from the asendindg ramus to second
molar region .
- Amucoperiosteal flap was reflected to expose the lateral mandibular ramus to the
posterior border and the sigmoid notch
- The intraoral vertical osteotomy is accomplished by using an oscillating saw to make the
cut from the sigmoid notch through the inferior border of the mandible. The osteotomy is
placed 5 mm anterior to the posterior border of the mandible to avoid injury to inferior
alveolar neurovascular bundle.
- Patient is placed in maxillomandibular fixation (MMF) using a prefabricated occlusal
splint to assure accuracy of the mandibular position.
follow up clinical and radiographic evaluation will be performed at the first week
postoperative then the patients will recalled for radiograghic evaluation at 2weeks and 2
months .finall follow up visit will be at 6 months postoperative
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