Some Ideas on Relapse After Remodeling of Prognathism: Aesthetic and Functional Results

Abstract.

The efficiency of a surgical treatment is evaluated, mainly, by the stability of the results achieved, whether they are functional, aesthetic, or psychological. Relapse is the greatest problem in prognathism surgery. Among the probable causes of relapse, muscular actions are the main one. The author emphasizes the value of complete preoperative preparation, which includes clinical, cephalometric, occlusal, and functional analysis, and presents his surgical program: complete detachment of the periosteum of the ramus on the muscular area (the pterygomasseteric belt), a different surgical technique, L sagittal subcondylian osteotomy, and a maxillomandibular fixation (MMF) of just 6 to 10 days. He compares the results: relapses fall from a mean of 20% or more to a mere 2.4%, recovery of almost-normal function is achieved after about 1 month, and the treatment is more safe and comfortable for the patient.