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Mandibular Medial Osteotomy Modifications and Postoperative Stability

Sponsor: Bezmialem Vakif University • ClinicalTrials.gov ID: NCT07788976

Registry updated: 2026-08-27

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Description

This study aims to compare the effects of the Hunsuck and Posnick modifications of medial mandibular osteotomy on postoperative skeletal stability and relapse in patients undergoing orthognathic surgery. The study will evaluate whether the choice of medial osteotomy technique influences postoperative mandibular relapse.

Interventions

sagittal split osteotomy (Procedure)
Bilateral sagittal split ramus osteotomy will be performed as part of orthognathic surgery to correct the planned mandibular skeletal deformity. The mandibular ramus and body will be divided using the assigned medial osteotomy modification (Hunsuck or Posnick), followed by sagittal splitting of the mandible. The distal mandibular segment will then be repositioned according to the preoperative surgical plan and stabilized using appropriate osteosynthesis. Postoperative skeletal stability and mandibular relapse will be evaluated during the follow-up period.
Hunsuck Modification of Medial Mandibular Osteotomy (Procedure)
The Hunsuck modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be initiated at the lingula and extended posteriorly for a short distance, according to the Hunsuck modification. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations
Posnick Modification Group (Procedure)
The Posnick modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be performed according to the Posnick modification, with the osteotomy design extending posteriorly along the medial aspect of the mandibular ramus as described for this technique. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations.

Eligibility criteria

Inclusion Criteria: 1. Patients with an indication for orthognathic surgery who are planned to undergo bimaxillary orthognathic surgery. 2. Patients who have undergone preoperative orthodontic treatment. 3. Patients aged 18-65 years. Exclusion Criteria: 1. Patients who develop an unfavorable split (bad split) during surgery. 2. Patients with cleft lip and palate, craniofacial syndromes, or a history of facial trauma. 3. Patients who have previously undergone orthognathic surgery and require revision surgery. 4. Patients whose computed tomography (CT) records are inadequate for the required measurements.

Conditions

Orthognathic Surgical Procedures

Locations

Bezmialem vakif university — Istanbul, Fatih, Turkey (Türkiye)

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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