Screw fixation following bilateral sagittal ramus osteotomy for mandibular advancement—complications in 700 consecutive cases

The use of transbuccal positional screws for stabilisation of bony segments following bilateral sagittal split osteotomy for mandibular advancement was assessed in 700 consecutive cases. In 19 patients (2.7% of cases) screw fixation was not used as the method of fixation. Screw removal was performed in 20 patients (2.8% of cases), in 15 cases due to infection and 5 cases for diverse reasons. The incidence of inferior alveolar nerve damage was increased when compared to a group of patients managed with intermaxillary fixation following advancement BSSO treated in the same unit. In 4 patients (0.6%) a lingual nerve dysaesthesia occurred. Screw loosening in the first postoperative week occurred in 4 patients and in 3 of these re-operation was necessary. Extra oral scar formation did not give rise to any significant problems.