Assessment of skeletal stability of intraoral vertical ramus osteotomy with one-day maxillary–mandibular fixation followed by early jaw exercise

Purpose: Intraoral vertical ramus osteotomy (IVRO) is an effective surgical technique for cases of mandibular setback, is simpler and has a lower incidence of mental paraesthesia when compared to sagittal split ramus osteotomy (SSRO). However, IVRO has a disadvantage in the prolonged duration of postoperative maxillary-mandibular fixation (MMF) required due to the absence of rigid bone fixation. To avoid an extended MMF period, we developed a postoperative management protocol for our IVRO patients, using jaw exercises with elastic bands starting on the second day after surgery. Methods: We evaluated the cephalometric skeletal and dental stabilities of 16 IVRO patients as they followed our protocol. Results: The stabilities were confirmed and were similar to those of previous reports. Conclusion: One-day MMF and early initiation of jaw exercise after IVRO did not affect the jaw position stability. Moreover, our findings suggest that starting jaw exercise earlier after IVRO surgery is beneficial, as it allows patients to avoid a long period of rigid MMF so that they can resume their normal daily activities sooner.
Journal of Cranio-Maxillofacial Surgery, 41(7), pp.586-592