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Is it necessary to use bone grafts to prevent defects at the lower border of the mandible after mandibular advancement?—a systematic review

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Abstract  

Introduction

Defects in the lower border of the mandible may represent an aesthetic problem after mandibular advancement in orthognathic surgery. The use of bone grafts has been reported in the literature as a possibility to reduce these defects in the postoperative period.

Objective

The objective of this systematic review is to answer the following research question: Is it necessary to use bone grafts to prevent defects at the lower border of the mandible after mandibular advancement?

Methods

The literature search was conducted on MEDLINE via PubMed, Scopus, Central Cochrane, Embase, LILACS, and Sigle via Open Gray up until December 2020. Five studies were eligible for this systematic review, considering the previously established inclusion and exclusion criteria.

Results

1340 mandibular osteotomies were evaluated, with a mean advance of 8 mm, being 510 with bone graft (42 defects), 528 without graft (329 defects), and 302 with an alternative technique (32 defects). Regarding the type of bone graft used, three articles used xenogenous or biomaterial grafts and two allogenous bone grafts. The results of the meta-analysis showed a reduction in the presence of defects in the bone graft group: OR 0.04, 95% CI = 0.01, 0.19; p = 0.0005, (I2 = 87%; p < 0.0001).

Conclusion

The use of bone grafts seems promising in reducing defects in the lower border of the mandible after mandibular advancement. New controlled prospective studies with a larger number of participants are needed to ensure the effectiveness of this procedure.

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Funding

This study did not receive any specific grants or aid from funding agencies in the public, commercial, or non-profit sectors.

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Authors and Affiliations

  1. Department of Prothesis and Oral and Maxillofacial Surgery Department, Postgraduate Program in Dentistry, Federal University of Pernambuco, Av. Prof. Moraes Rego 1235 – Cidade Universitária, Recife, PE, 50670-901, Brazil

    Pedro Henrique da Hora Sales

  2. Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy

    Francesco Maffìa

  3. Department of Maxillofacial Surgery, S. Maria Hospital, Terni, Italy

    Valentino Vellone

  4. Ortognatica Roma, Rome, Italy

    Valerio Ramieri

  5. Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, PE, Brazil

    Jair Carneiro Leão

Authors
  1. Pedro Henrique da Hora Sales
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  2. Francesco Maffìa
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  3. Valentino Vellone
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  4. Valerio Ramieri
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  5. Jair Carneiro Leão
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Correspondence to Pedro Henrique da Hora Sales.

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da Hora Sales, P.H., Maffìa, F., Vellone, V. et al. Is it necessary to use bone grafts to prevent defects at the lower border of the mandible after mandibular advancement?—a systematic review. Oral Maxillofac Surg 27, 581–589 (2023). https://doi.org/10.1007/s10006-022-01112-8

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  • DOI: https://doi.org/10.1007/s10006-022-01112-8

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