Complications after mandibular setback with intraoral vertical ramus osteotomies: a retrospective cohort analysis of 133 patients

Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jun;131(6):638-642. doi: 10.1016/j.oooo.2021.01.008. Epub 2021 Jan 9.


Objective: In the present study, we assessed the rate of complications and morbidity after mandibular setback with bilateral intraoral vertical ramus osteotomy (IVRO).

Study design: In total, 133 patients were included. The prevalence of neurosensory disturbance (NSD), surgical site infection (SSI), and other complications were registered 2 months and 1 year after surgery. The correlations between complications and age, sex, American Society of Anesthesiologists classification, body mass index, blood loss, and operative time were evaluated.

Results: NSD was reported for 6.8% of the patients (9 of 133) 2 months after surgery (3.8% of the operated sites). The prevalence was significantly higher in female patients (P < .05). Two patients described persistent unilateral reduced sensibility after 1 year (1.5%). In total, 0.8% of the operated sites (2 of 266) had persistent NSD after 1 year. None of the patients required prolonged hospitalization, and 95.5% (127 of 133) were discharged the day after surgery. None of the patients experienced severe bleeding, and only 1 patient developed SSI. There were no significant correlations between patient-specific or intraoperative parameters evaluated and registered complications.

Conclusions: This study shows that IVRO is a safe surgical technique associated with a low complication rate. IVRO can be an alternative technique for mandibular setback in patients who can tolerate postoperative maxillomandibular fixation.

MeSH terms

  • Cephalometry
  • Cohort Studies
  • Female
  • Humans
  • Mandible
  • Osteotomy, Sagittal Split Ramus / adverse effects
  • Prognathism*
  • Retrospective Studies