Maintenance of soft tissue changes after rigid versus wire fixation for mandibular advancement, with and without genioplasty

Objective. This multisite prospective randomized clinical trial examined 2- year longitudinal soft tissue profile changes after bilateral sagittal spli t osteotomy for mandibular advancement by using rigid or wire fixation, wit h and without genioplasty. Study design. The study sample consisted of 127 subjects. The rigid-fixatio n group (n = 78) received 2-mm bicortical position screws, whereas the wire -fixation group (n = 49) received inferior border wires. In the rigid-fixat ion group, 35 subjects underwent genioplasty, whereas 24 subjects underwent genioplasty in the wire-fixation group. Soft tissue profile changes of lab rale inferius, B-point, and pogonion were obtained from digitized cephalome tric films taken immediately before surgery and up to 2 years after surgery . Results. Regardless of fixation technique, subjects who had genioplasty in conjunction with the mandibular advancement had the largest surgical moveme nt and the largest postsurgical change (P < .05). When all variables were c onstant, fixation technique was associated with maintenance of soft tissue change. Subjects who underwent rigid fixation maintained more soft tissue c hange than patients who underwent wire fixation. Conclusions. These findings suggest that subjects undergoing rigid fixation and genioplasty maintained the most soft tissue advancement.