Research Paper

Journal of Maxillofacial and Oral Surgery

, Volume 13, Issue 4, pp 471-477

First online:

Skeletal Relapse After Mandibular Setback in Bi Max Surgery: Intraoral Vertical Ramus versus Bilateral Sagittal Split Osteotomies

  • Ra’ed M. A. Al-DelaymeAffiliated withOral and Maxillofacial Surgery Department, Faculty of Dentistry, Al-Rafidain University CollegeOral and Maxillofacial Surgery Department, AL-Yarmuk Teaching Hospital Email author 
  • , Moutaz Al-KhenAffiliated withOral and Maxillofacial Surgery Department, Damascus Hospital, Ministry of Health

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access



This study aimed to measure and compare the postoperative horizontal and vertical changes (relapse) that occur at B point and pogonion after intraoral vertical ramus osteotomy (IVRO) without fixation and bilateral sagittal split osteotomy (BSSO) with semi rigid internal fixation in bimax surgery.

Materials and Methods

Eleven patients with skeletal class III malocclusion mandibular prognathism and maxillary hypoplasia were chosen. Six cases underwent BSSO; and five IVRO. All patients underwent Lefort I osteotomy without genioplasty.


Postoperative changes (relapse) of B-point and pogonion in horizontal and vertical axes from 1 week post operatively (T0) to 1 year post operatively (T2) were assessed and the percentage of relapse of each point and each axis was compared. It was noted that the horizontal relapse in IVRO was 27.7 % at B point and 40.6 % at pogonion while, in BSSO group it was noted that the horizontal relapse was 28.1 % at B point and a greater number i.e., 40.9 % at pogonion.


The percentage of horizontal relapse after IVRO without fixation is equal to that after BSSO with semi rigid internal fixation.


Relapse B point Pogonion Vertical ramus osteotomy (IVRO) Bilateral sagital split osteotomy (BSSO)