This study aims to investigate all papers on orthognathic fixation to better understand changes in operative techniques and fixation materials and to better compare relapse and complication rates.
Methods:
A PubMed search was conducted of “orthognathic” AND “fixation” in the title or abstract between 1989 and 2020.
Results:
Three reviewers independently screened 439 papers and extracted data from 166 included papers. Of these studies, 118 investigated sagittal split ramus osteotomies (SSRO), 96 LeFort osteotomies, 25 genioplasties, and 21 intraoral vertical ramus osteotomies (IVRO). The most used fixation materials in the maxilla were titanium miniplates with monocortical screws (n = 65), followed by resorbable miniplates (n = 10); in the mandible, the most common were titanium miniplates (n = 67) and titanium bicortical screws (n = 49). Wide variability was demonstrated in relapse rates by operation, fixation type, and relapse time-point studied. Meta-analysis revealed a significantly higher infection rate in SSRO versus LeFort (P = .003) and, surprisingly, a trend toward higher relapse rate in titanium versus resorbable fixation at 6 months in SSRO setback (P = .08).
Conclusion:
This study reports all the available data on relapse rates across techniques, with non-inferiority of bicortical screws versus miniplates.
LinH-HLonicDLoL-J.3D printing in orthognathic surgery - a literature review. J Formos Med Assoc. 2018;117(7):547-558. doi:10.1016/j.jfma.2018.01.008
2.
PosnickJC. Definition and prevalence of dentofacial deformities. In: PosnickJC, ed. Principles and Practice of Orthognathic Surgery. W.B. Saunders; 2014:61-68.
3.
TanSKLeungWKTangATHTseECMZwahlenRA.Orthognathic relevant scales of FACE-Q: translation and validation for Hong Kong Chinese patients. Plast Reconstr Surg Glob Open. 2017;5(12):e1608. doi:10.1097/GOX.0000000000001608
4.
CarmodyJBGreenLMKigerPG, et al. Medical student attitudes toward USMLE Step 1 and Health Systems Science – a multi-institutional survey. Teach Learn Med. 2021;33(2):139-153. doi:10.1080/10401334.2020.1825962
5.
ZaroniFMCavalcanteRCJoão da CostaDKluppelLEScariotRRebellatoNLB. Complications associated with orthognathic surgery: a retrospective study of 485 cases. J Craniomaxillofac Surg. 2019;47(12):1855-1860. doi:10.1016/j.jcms.2019.11.012
6.
KimS-GParkS-S.Incidence of complications and problems related to orthognathic surgery. J Oral Maxillofac Surg. 2007;65(12):2438-2444. doi:10.1016/j.joms.2007.05.030
7.
ChowLKSinghBChiuWKSammanN.Prevalence of postoperative complications after orthognathic surgery: a 15-year review. J Oral Maxillofac Surg. 2007;65(5):984-992. doi:10.1016/j.joms.2006.07.006
8.
RamasubbuSWahabAKumarMPS. Incidence of miniplate removal following its fixation in maxillofacial surgery - a retrospective study. Int J Dent Oral Sci. 2020;5:144-146.
9.
O’ConnellJMurphyCIkeagwuaniOAdleyCKearnsG.The fate of titanium miniplates and screws used in maxillofacial surgery: a 10 year retrospective study. Int J Oral Maxillofac Surg. 2009;38:731-735. doi:10.1016/j.ijom.2009.02.016
10.
LittleMLangfordRJBhanjiAFarrD.Plate removal following orthognathic surgery. J Craniomaxillofac Surg. 2015;43(9):1705-1709. doi:10.1016/j.jcms.2015.07.010
11.
HanJJYangHJLeeS-JHwangSJ.Relapse after SSRO for mandibular setback movement in relation to the amount of mandibular setback and intraoperative clockwise rotation of the proximal segment. J Craniomaxillofac Surg. 2014;42(6):811-815. doi:10.1016/j.jcms.2013.11.018
12.
DowlingPAEspelandLSandvikLMobarakKAHogevoldHE.LeFort I maxillary advancement: 3-year stability and risk factors for relapse. Am J Orthod Dentofacial Orthop. 2005;128:560-567. doi:10.1016/j.ajodo.2004.07.051
13.
Herrera-VizcainoCSeifertLBerdanM, et al. Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article). Clin Oral Investig. 2021;25(5):3229-3236. doi:10.1007/s00784-020-03653-2
PelegOMahmoudRShusterA, et al. Orthognathic surgery complications: the 10-year experience of a single center. J Craniomaxillofac Surg. 2021;49:891-897. doi:10.1016/j.jcms.2021.04.006
16.
de HaanIFCiesielskiRNitscheTKoosB.Evaluation of relapse after orthodontic therapy combined with orthognathic surgery in the treatment of skeletal Class III. J Orofac Orthop. 2013;74(5):362-369. doi:10.1007/s00056-013-0161-0
17.
ProffitWRTurveyTAPhillipsC.The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med. 2007;3(1):21. doi:10.1186/1746-160X-3-21
FarrellBBFrancoPBTuckerMR.Virtual surgical planning in orthognathic surgery. Oral Maxillofac Surg Clin North Am. 2014;26(4):459-473. doi:10.1016/j.coms.2014.08.011
20.
LimYNParkIYKimJCByunSHYangBE.Comparison of changes in the condylar volume and morphology in Skeletal Class III deformities undergoing orthognathic surgery using a customized versus conventional miniplate: a retrospective analysis. J Clin Med. 2020;9(9):E2794. doi:10.3390/jcm9092794
21.
BeylerEAltıparmakNBayramB.Comparison of the postoperative stability after repositioning of the maxilla with Le Fort I osteotomy using four- versus two-plate fixation. J Stomatol Oral Maxillofac Surg. 2021;122(2):156-161. doi:10.1016/j.jormas.2020.05.011
22.
HuangMFAlfiDAlfiJHuangAT.The use of patient-specific implants in oral and maxillofacial surgery. Oral Maxillofac Surg Clin North Am. 2019;31(4):593-600. doi:10.1016/j.coms.2019.07.010
23.
KerseyMLNebbeBMajorPW.Temporomandibular joint morphology changes with mandibular advancement surgery and rigid internal fixation: a systematic literature review. Angle Orthod. 2003;73(1):79-85. doi:10.1043/0003-3219(2003)073<0079:tjmcwm>2.0.CO;2
24.
TuckerMR.Orthognathic surgery versus orthodontic camouflage in the treatment of mandibular deficiency. J Oral Maxillofac Surg. 1995;53(5):572-578. doi:10.1016/0278-2391(95)90071-3
25.
SchneiderMErasmusFGerlachKL, et al. Open reduction and internal fixation versus closed treatment and mandibulomaxillary fixation of fractures of the mandibular condylar process: a randomized, prospective, multicenter study with special evaluation of fracture level. J Oral Maxillofac Surg. 2008;66(12):2537-2544. doi:10.1016/j.joms.2008.06.107
26.
CorneliusCPEhrenfeldM.The use of MMF screws: surgical technique, indications, contraindications, and common problems in review of the literature. Craniomaxillofac Trauma Reconstr. 2010;3(2):55-80. doi:10.1055/s-0030-1254376
27.
LopezJLakeIVKhavaninN, et al. Noninvasive management of pediatric isolated, condylar fractures: less is more?. Plast Reconstr Surg. 2021;147(2):443-452. doi:10.1097/PRS.0000000000007527
28.
UekiKOkabeKMiyazakiM, et al. Skeletal stability after mandibular setback surgery: comparisons among unsintered hydroxyapatite/poly-L-lactic acid plate, poly-L-lactic acid plate, and titanium plate. J Oral Maxillofac Surg. 2011;69(5):1464-1468. doi:10.1016/j.joms.2010.06.187
29.
CheungLKChowLKChiuWK.A randomized controlled trial of resorbable versus titanium fixation for orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(4):386-397. doi:10.1016/j.tripleo.2004.02.069
30.
BallonALaudemannKSaderRLandesCA.Segmental stability of resorbable P(L/DL)LA-TMC osteosynthesis versus titanium miniplates in orthognatic surgery. J Craniomaxillofac Surg. 2012;40(8):e408-e414. doi:10.1016/j.jcms.2012.02.014
31.
MearaDJKnollMRHolmesJDClarkDM.Fixation of Le Fort I osteotomies with poly-DL-lactic acid mesh and ultrasonic welding—a new technique. J Oral Maxillofac Surg. 2012;70(5):1139-1144. doi:10.1016/j.joms.2011.03.011
32.
SchneiderMStadlingerBLoukotaREckeltU.Three-dimensional fixation of fractures of the mandibular condyle with a resorbable three-dimensional osteosynthesis mesh. Br J Oral Maxillofac Surg. 2012;50(5):470-473. doi:10.1016/j.bjoms.2011.11.006
33.
HeufelderMWildeFPietzkaS, et al. Clinical accuracy of waferless maxillary positioning using customized surgical guides and patient specific osteosynthesis in bimaxillary orthognathic surgery. J Craniomaxillofac Surg. 2017;45(9):1578-1585. doi:10.1016/j.jcms.2017.06.027
34.
SuojanenJLeikolaJStoorP.The use of patient-specific implants in orthognathic surgery: a series of 30 mandible sagittal split osteotomy patients. J Craniomaxillofac Surg. 2017;45(6):990-994. doi:10.1016/j.jcms.2017.02.021
35.
LatifoğluOAyhanSAtabayK.Total face reconstruction: skin graft versus free flap. Plast Reconstr Surg. 1999;103(3):1076-1078.
36.
SittitavornwongSWaitePDDannJJKohnMW.The stability of maxillary osteotomies fixated with biodegradable mesh in orthognathic surgery. J Oral Maxillofac Surg. 2006;64(11):1631-1634. doi:10.1016/j.joms.2006.06.278
37.
SusarlaSMEttingerRPrestonKKapadiaHEgbertMA.Two-point nasomaxillary fixation of the Le Fort I osteotomy: assessment of stability at one year postoperative. Int J Oral Maxillofac Surg. 2020;49(4):466-470. doi:10.1016/j.ijom.2019.08.006
38.
SusarlaSMEttingerREPrestonKKapadiaHEgbertMA.Is alteration of the occlusal plane stable with isolated nasomaxillary fixation of the Le Fort I osteotomy?Int J Oral Maxillofac Surg. 2020;49(7):895-900. doi:10.1016/j.ijom.2019.12.004
39.
CheungLKChuaHDPHäggMB.Cleft maxillary distraction versus orthognathic surgery: clinical morbidities and surgical relapse. Plast Reconstr Surg. 2006;118(4):996-1008. doi:10.1097/01.prs.0000232358.31321.ea
40.
KotaniemiKVMHeliövaaraAKotaniemiM, et al. Comparison of postoperative skeletal stability of maxillary segments after Le Fort I osteotomy, using patient-specific implant versus mini-plate fixation. J Craniomaxillofac Surg. 2019;47(7):1020-1030. doi:10.1016/j.jcms.2019.04.003
41.
NoohN.Stability of the mandible after bilateral sagittal split osteotomy: comparison between positioning screws and plate. Saudi Dent J. 2009;21(3):123-126. doi:10.1016/j.sdentj.2009.10.003
42.
LandesCABallonASaderR.Segment stability in bimaxillary orthognathic surgery after resorbable poly(L-lactide-co-glycolide) versus titanium osteosyntheses. J Craniofac Surg. 2007;18(5):1216-1229. doi:10.1097/scs.0b013e31814b29df
43.
RaoSHSelvarajLLankupalliAS.Skeletal stability after bilateral sagittal split advancement and setback osteotomy of the mandible with miniplate fixation. Craniomaxillofac Trauma Reconstr. 2014;7(1):9-16. doi:10.1055/s-0033-1356763
44.
SatoFRAsprinoLFernandes MoreiraRWde MoraesM.Comparison of postoperative stability of three rigid internal fixation techniques after sagittal split ramus osteotomy for mandibular advancement. J Craniomaxillofac Surg. 2014;42(5):e224-e229. doi:10.1016/j.jcms.2013.08.012
45.
van BakelenNBBoermansBDBuijsGJ, et al. Comparison of the long-term skeletal stability between a biodegradable and a titanium fixation system following BSSO advancement—a cohort study based on a multicenter randomised controlled trial. Br J Oral Maxillofac Surg. 2014;52(8):721-728. doi:10.1016/j.bjoms.2014.06.014
46.
MaviliMECanterHISaglam-AydinatayB.Semirigid fixation of mandible and maxilla in orthognathic surgery: stability and advantages. Ann Plast Surg. 2009;63(4):396-403. doi:10.1097/SAP.0b013e318190322f
47.
HanJJHwangSJ.Three-dimensional analysis of postoperative returning movement of perioperative condylar displacement after bilateral sagittal split ramus osteotomy for mandibular setback with different fixation methods. J Craniomaxillofac Surg. 2015;43(9):1918-1925. doi:10.1016/j.jcms.2015.08.004
48.
KimYKKimYJYunPYKimJW.Evaluation of skeletal and surgical factors related to relapse of mandibular setback surgery using the bioabsorbable plate. J Craniomaxillofac Surg. 2009;37(2):63-68. doi:10.1016/j.jcms.2008.10.011
49.
ParkYWKangHSLeeJH.Comparative study on long-term stability in mandibular sagittal split ramus osteotomy: hydroxyapatite/poly-l-lactide mesh versus titanium miniplate. Maxillofac Plast Reconstr Surg. 2019;41(1):8. doi:10.1186/s40902-019-0192-6
50.
RohYCShinSHKimSSSandorGKKimYD.Skeletal stability and condylar position related to fixation method following mandibular setback with bilateral sagittal split ramus osteotomy. J Craniomaxillofac Surg. 2014;42(8):1958-1963. doi:10.1016/j.jcms.2014.08.008
51.
LeeJYKimYKYunPYLeeNKKimJWChoiJH.Evaluation of stability after orthognathic surgery with minimal orthodontic preparation: comparison according to 3 types of fixation. J Craniofac Surg. 2014;25(3):911-915. doi:10.1097/SCS.0000000000000609
52.
PaengJYHongJKimCSKimMJ.Comparative study of skeletal stability between bicortical resorbable and titanium screw fixation after sagittal split ramus osteotomy for mandibular prognathism. J Craniomaxillofac Surg. 2012;40(8):660-664. doi:10.1016/j.jcms.2011.11.001
53.
LuchiGHConciRATomaziFH, et al. Assessment of the postoperative stability of Mandibular orthognathic surgery for correction of Class III skeletal malocclusion. J Craniofac Surg. 2017;28(1):151-156. doi:10.1097/SCS.0000000000003311
54.
JafarianMAlamMShafieiSMoslemiHTabriziR.Effect of fixation method on intergonial width stability after mandibular setback via bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg. 2020;49(11):1430-1434. doi:10.1016/j.ijom.2020.04.006
55.
RochaVÁNetoAIRebelloIM, et al. Skeletal stability in orthognathic surgery: evaluation of methods of rigid internal fixation after counterclockwise rotation in patients with Class II deformities. Br J Oral Maxillofac Surg. 2015;53(8):730-735. doi:10.1016/j.bjoms.2015.05.002
56.
ChoiSHYooHJLeeJYJungYSChoiJWLeeKJ.Stability of pre-orthodontic orthognathic surgery depending on mandibular surgical techniques: SSRO vs IVRO. J Craniomaxillofac Surg. 2016;44(9):1209-1215. doi:10.1016/j.jcms.2016.07.020
57.
KitaharaTNakasimaAKuraharaSShiratsuchiY.Hard and soft tissue stability of orthognathic surgery. Angle Orthod. 2009;79(1):158-165. doi:10.2319/122707-604.1
58.
BergerJLPangrazio-KulbershVBacchusSNKaczynskiR.Stability of bilateral sagittal split ramus osteotomy: rigid fixation versus transosseous wiring. Am J Orthod Dentofacial Orthop. 2000;118(4):397-403. doi:10.1067/mod.2000.108781
59.
KungAYHLeungYY.Stability of intraoral vertical ramus osteotomies for mandibular setback: a longitudinal study. Int J Oral Maxillofac Surg. 2018;47(2):152-159. doi:10.1016/j.ijom.2017.09.004
60.
Schilbred EriksenEWisthPJLøesSMoenK. Skeletal and dental stability after intraoral vertical ramus osteotomy: a long-term follow-up. Int J Oral Maxillofac Surg. 2017;46(1):72-79. doi:10.1016/j.ijom.2016.07.004
61.
LaiSSTsengYCHuangIYYangYHShenYSChenCM.Skeletal changes after modified intraoral vertical ramus osteotomy for correction of mandibular prognathism. J Plast Reconstr Aesthet Surg. 2007;60(2):139-145. doi:10.1016/j.bjps.2006.04.001
62.
KimJYParkJHJungHDJungYS.Safety and stability of postponed maxillomandibular fixation after intraoral vertical ramus osteotomy. J Craniofac Surg. 2018;29(8):2226-2230. doi:10.1097/SCS.0000000000005025
63.
VerweijJPHassingGJMFioccoMHouppermansPNWvan MerkesteynJPR. Removal of osteosynthesis material because of symptoms after Le Fort I osteotomy: a retrospective study of 158 patients. J Craniomaxillofac Surg. 2016;44(12):1909-1912. doi:10.1016/j.jcms.2016.09.009
64.
FrisciaMSbordoneCPetrocelliM, et al. Complications after orthognathic surgery: our experience on 423 cases. Oral Maxillofac Surg. 2017;21(2):171-177. doi:10.1007/s10006-017-0614-5
65.
RausoRTartaroGSteaSTozziUBiondiP.Plates removal in orthognathic surgery and facial fractures: when and why. J Craniofac Surg. 2011;22(1):252-254. doi:10.1097/SCS.0b013e3181f7b7f4
66.
PosnickJCChoiEChavdaA.Method of osteotomy fixation and need for removal following bimaxillary orthognathic, osseous genioplasty, and intranasal surgery: a retrospective cohort study. Int J Oral Maxillofac Surg. 2017;46(10):1276-1283. doi:10.1016/j.ijom.2017.05.014
67.
ManorYChaushuGTaicherS.Risk factors contributing to symptomatic plate removal in orthognathic surgery patients. J Oral Maxillofac Surg. 1999;57(6):679-682. doi:10.1016/s0278-2391(99)90430-5
68.
HoMWBoyleMACooperJCDoddMDRichardsonD.Surgical complications of segmental le Fort I osteotomy. Br J Oral Maxillofac Surg. 2011;49(7):562-566. doi:10.1016/j.bjoms.2010.09.018
69.
HeidemannWGerlachKL.Clinical applications of drill free screws in maxillofacial surgery. J Craniomaxillofac Surg. 1999;27(4):252-255. doi:10.1016/s1010-5182(99)80037-7
70.
SuojanenJJärvinenSKotaniemiKV, et al. Comparison between patient specific implants and conventional mini-plates in Le Fort I osteotomy with regard to infections: no differences in up to 3-year follow-up. J Craniomaxillofac Surg. 2018;46(10):1814-1817. doi:10.1016/j.jcms.2018.07.011
71.
DavisCMGregoireCEDavisISteevesTW.Prevalence of surgical site infections following orthognathic surgery: a double-blind, randomized controlled trial on a 3-day versus 1-day postoperative antibiotic regimen. J Oral Maxillofac Surg. 2017;75(4):796-804. doi:10.1016/j.joms.2016.09.038
72.
ShandJMHeggieAA.Use of a resorbable fixation system in orthognathic surgery. Br J Oral Maxillofac Surg. 2000;38(4):335-337. doi:10.1054/bjom.1999.0287
73.
LainePKontioRLindqvistCSuuronenR.Are there any complications with bioabsorbable fixation devices? A 10 year review in orthognathic surgery. Int J Oral Maxillofac Surg. 2004;33(3):240-244. doi:10.1006/ijom.2003.0510
74.
CottrellDAWolfordLM.Long-term evaluation of the use of coralline hydroxyapatite in orthognathic surgery. J Oral Maxillofac Surg. 1998;56(8):935-941. doi:10.1016/s0278-2391(98)90654-1
TurveyTAProffitWPPhillipsC.Biodegradable fixation for craniomaxillofacial surgery: a 10-year experience involving 761 operations and 745 patients. Int J Oral Maxillofac Surg. 2011;40(3):244-249. doi:10.1016/j.ijom.2010.11.024
77.
TamuraNTakakiTTakanoNShibaharaT.Three-dimensional finite element analysis of bone fixation in bilateral sagittal split ramus osteotomy using individual models. Bull Tokyo Dent Coll. 2018;59(2):67-78. doi:10.2209/tdcpublication.2013-3000
78.
LeungYYWangRWongNSM, et al. Surgical morbidities of sagittal split ramus osteotomy versus intraoral vertical ramus osteotomy for the correction of mandibular prognathism: a randomized clinical trial. Int J Oral Maxillofac Surg. 2021;50(7):933-939. doi:10.1016/j.ijom.2020.06.023
79.
SuojanenJJärvinenSHodzicZReunanenJLeikolaJStoorP.No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy - up to 3-year follow-up. J Craniomaxillofac Surg. 2019;47(8):1181-1184. doi:10.1016/j.jcms.2018.10.009
80.
IannettiGFaddaTMRiccardiEMitroVFiliaciF.Our experience in complications of orthognathic surgery: a retrospective study on 3236 patients. Eur Rev Med Pharmacol Sci. 2013;17(3):379-384.
81.
BecelliRFiniGRenziGGiovannettiFRoefaroE.Complications of bicortical screw fixation observed in 482 mandibular sagittal osteotomies. J Craniofac Surg. 2004;15(1):64-68. doi:10.1097/00001665-200401000-00019
82.
KimNKNamWKimHJ.Comparison of miniplates and biodegradable plates in reconstruction of the mandible with a fibular free flap. Br J Oral Maxillofac Surg. 2015;53(3):223-229. doi:10.1016/j.bjoms.2014.11.010
83.
YlikontiolaLSundqvuistKSàndorGKBTörmäläPAshammakhiN.Self-reinforced bioresorbable poly-L/DL-lactide [SR-P(L/DL)LA] 70/30 miniplates and miniscrews are reliable for fixation of anterior mandibular fractures: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(3):312-317. doi:10.1016/j.tripleo.2003.10.030
84.
MittalGDubbuduRRCariappaKM.Three dimensional titanium mini plates in oral & maxillofacial surgery: a prospective clinical trial. J Maxillofac Oral Surg. 2012;11(2):152-159. doi:10.1007/s12663-011-0267-0
85.
AttishiaRVan SickelsJECunninghamLL.Incidence of bracket failure during orthognathic surgery: a comparison of two techniques to establish interim maxillomandibular fixation. Oral Maxillofac Surg. 2015;19(2):143-147. doi:10.1007/s10006-014-0468-z
86.
MaurerPOttoCEckertAWSchubertJ.[Complications in surgical treatment of malocclusions. Report of 50 years experience]. Mund Kiefer Gesichtschir. 2001;5(6):357-361. doi:10.1007/s10006-001-0342-7
87.
WidarFAfshariMRasmussonLDahlinCKashaniH.Incidence and risk factors predisposing plate removal following orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;124(3):231-239. doi:10.1016/j.oooo.2017.04.016
88.
AhnYSKimSGBaikSM, et al. Comparative study between resorbable and nonresorbable plates in orthognathic surgery. J Oral Maxillofac Surg. 2010;68(2):287-292. doi:10.1016/j.joms.2009.07.020
89.
MoenningJEWolfordLM.Coralline porous hydroxyapatite as a bone graft substitute in orthognathic surgery: 24-month follow-up results. Int J Adult Orthodon Orthognath Surg. 1989;4(2):105-117.
90.
BaartJAVlotP.[Infections along trans-mucosal fixation wires]. Acta Stomatol Belg. 1990;87(4):283-289.
91.
AndrupMEleniusJRamìrezERNSjöströmM. Indications and frequency of orthognathic surgery in Sweden-a questionnaire survey. Int J Oral Dent Health. 2015;1:19.
92.
AlhammadiMSHalboubEFayedMSLabibAEl-SaaidiC.Global distribution of malocclusion traits: a systematic review. Dent Press J Orthod. 2018;23(6):40e1-40e10. doi:10.1590/2177-6709.23.6.40.e1-10.onl
93.
HardyDKCubasYPOrellanaMF.Prevalence of angle Class III malocclusion: a systematic review and meta-analysis. Open J Epidemiol. 2012;02:75-82. doi:10.4236/ojepi.2012.24012
94.
AgnihotryAFedorowiczZNasserMGillKS.Resorbable versus titanium plates for orthognathic surgery. Cochrane Database Syst Rev. 2017;10:CD006204. doi:10.1002/14651858.CD006204.pub3
95.
YuSBloomquistD.Can resorbable screws effectively be used in fixating bilateral sagittal split osteotomies for mandibular advancement? A randomized controlled trial. J Oral Maxillofac Surg. 2014;72(11):2273-2277. doi:10.1016/j.joms.2014.04.033
