Mandibular Medial Osteotomy Modifications and Postoperative Stability

NCT07788976 | Recruiting

• 1 other identifier: E.224971
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effects of the Hunsuck and Posnick modifications of medial mandibular osteotomy on postoperative skeletal stability and relapse in patients undergoing orthognathic surgery. The study will evaluate whether the choice of medial osteotomy technique influences postoperative mandibular relapse.

Conditions

Orthognathic Surgical Procedures

Keywords

orthognathic surgery; relapse

Outcome Measures

Primary Outcomes (1)

• Postoperative Skeletal Relapse

  The primary outcome will be the amount and percentage of skeletal relapse between 1 month and 12 months after orthognathic surgery (T3-T1), assessed using three-dimensional cephalometric and skeletal measurements.

  1 year

Study Arms (2)

Hunsuck Modification Group

EXPERIMENTAL

Patients undergoing orthognathic surgery with bilateral sagittal split ramus osteotomy (BSSO) will undergo medial mandibular osteotomy using the Hunsuck modification. The osteotomy will be performed according to the Hunsuck technique, with the medial horizontal osteotomy terminating at the level of the lingula and extending posteriorly to facilitate the sagittal split. Postoperative skeletal stability and relapse will be evaluated during the follow-up period.

Procedure: sagittal split osteotomy; Procedure: Hunsuck Modification of Medial Mandibular Osteotomy

Posnick Modification Group

ACTIVE COMPARATOR

Patients undergoing orthognathic surgery with bilateral sagittal split ramus osteotomy (BSSO) will undergo medial mandibular osteotomy using the Posnick modification. The osteotomy will be performed according to the Posnick technique, with the modified medial osteotomy design extending posteriorly in accordance with the technique. Postoperative skeletal stability and relapse will be evaluated during the follow-up period.

Procedure: sagittal split osteotomy; Procedure: Posnick Modification Group

Interventions

sagittal split osteotomy PROCEDURE

Bilateral sagittal split ramus osteotomy will be performed as part of orthognathic surgery to correct the planned mandibular skeletal deformity. The mandibular ramus and body will be divided using the assigned medial osteotomy modification (Hunsuck or Posnick), followed by sagittal splitting of the mandible. The distal mandibular segment will then be repositioned according to the preoperative surgical plan and stabilized using appropriate osteosynthesis. Postoperative skeletal stability and mandibular relapse will be evaluated during the follow-up period.

Hunsuck Modification Group; Posnick Modification Group

Hunsuck Modification of Medial Mandibular Osteotomy PROCEDURE

The Hunsuck modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be initiated at the lingula and extended posteriorly for a short distance, according to the Hunsuck modification. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations

Hunsuck Modification Group

Posnick Modification Group PROCEDURE

The Posnick modification of the medial mandibular osteotomy will be performed during bilateral sagittal split ramus osteotomy (BSSO). The medial horizontal osteotomy will be performed according to the Posnick modification, with the osteotomy design extending posteriorly along the medial aspect of the mandibular ramus as described for this technique. The remaining steps of the BSSO will be performed using the standard surgical technique. Postoperative skeletal stability and relapse will be assessed using preoperative, immediate postoperative, and follow-up radiographic evaluations.

Posnick Modification Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with an indication for orthognathic surgery who are planned to undergo bimaxillary orthognathic surgery.
• Patients who have undergone preoperative orthodontic treatment.
• Patients aged 18-65 years.

You may not qualify if:

• Patients who develop an unfavorable split (bad split) during surgery.
• Patients with cleft lip and palate, craniofacial syndromes, or a history of facial trauma.
• Patients who have previously undergone orthognathic surgery and require revision surgery.
• Patients whose computed tomography (CT) records are inadequate for the required measurements.

Sponsors & Collaborators

• Bezmialem Vakif University: lead

Study Sites (1)

Bezmialem vakif university

Istanbul, Fatih, 34093, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Recurrence

Interventions

Osteotomy, Sagittal Split Ramus

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Oral Surgical Procedures; Surgical Procedures, Operative; Osteotomy; Orthopedic Procedures; Dentistry

Central Study Contacts

Emine Fulya Akkoyun, Dr.

CONTACT

+905372676871; efulyaakkoyun@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 24, 2026
• First Posted: August 27, 2026
• Study Start: January 1, 2026
• Primary Completion (Estimated): December 28, 2026
• Study Completion (Estimated): April 25, 2027
• Last Updated: August 27, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)