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Patient Specific Intraoral Inverted-L Osteotomy Modified With Inferior Alveolar Nerve Relocation in Corrective Mandibular Surgery

Not Applicable
Completed
Conditions
Class III Malocclusion
Interventions
Procedure: patient specific inverted L mandibular osteotomy modified with inferior alveolar nerve relocation
Registration Number
NCT05397002
Lead Sponsor
Cairo University
Brief Summary

Bilateral sagittal split osteotomy (BSSO) is considered the main osteotomy design in corrective mandibular surgery, however abnormal anatomical configuration of the posterior mandible with rolled out inferior border and thin mandibular rami with cortically adherent inferior alveolar nerve may interfere with the utilization of this osteotomy. The aim of this study is to introduce a novel modification of the intraoral inverted L ramus osteotomy (ILRO) to overcome these limitations in mandibular setback surgery. preoperative CBCT was requested for virtual planning and fabrication of cutting and drilling guides. Cutting lines were outlined to be consisted of four cuts; lateral ostectomy to uncover and lateralize the inferior alveolar nerve (IAN), posterior cut run horizontally from the anterior border of the ramus to a point just above the mandibular foramen, two anterior vertical cuts run from the anterior end of the lateral ostectomy to the inferior mandibular border. The guide was removed and the osteotomy lines were completed then the mandibular setback was oriented and fixed using pre-bent plates osteosynthesis. Inferior alveolar nerve function was regained perfectly one year post-operatively. This procedure introduces a robust alternative to the BSSO osteotomy in some cases of mandibular setback surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Adult patients.
  • patients with skeletal class III malocclusion.
  • Patients with thin mandibular rami with minimal medullary bone.
  • Patients with inferior alveolar nerve proximity to the buccal cortex.
  • Patients with lateral bending of the inferior mandibular border at molar angle region.
  • Patients with high mandibular foramen.
Exclusion Criteria
  • Patients with previous extensive jaw surgery.
  • mandibular pathological lesions.
  • Patients with temporomandibular joint dysfunction.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Patient with class III malocclusionpatient specific inverted L mandibular osteotomy modified with inferior alveolar nerve relocation-
Primary Outcome Measures
NameTimeMethod
Neurosensory dysfunction of Inferior Alveolar Nerveone year after surgical intervention

Neurosensory test: two-point discrimination test

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Faculty of Dentistry

🇪🇬

Cairo, Egypt

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