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Comparison of relapse rates, postoperative infections and operation time between BSSO and DO: a meta-analysis

Dan Ding Wu, Rong Zhou, Han He, Yue Huang

Abstract


Purpose: Differences in common complications and operation times suggest that complications after mandibular advancement surgery for Class II mandibular hypoplasia using bilateral sagittal split ramus osteotomy (BSSO) and distraction osteogenesis (DO) require further evaluation. The aim here is to compare relapse and postoperative infection incidences and operation times by meta-analysis to provide information for surgeons in selecting the appropriate surgical method and to inform patients about the complication risks of both.

Method: A comprehensive search using Medline, PubMed, Web of Science, Cochrane Library, EBSCO, CQVIP, CBA, CNKI, and SinoMed and the Internet until February 2017 was performed. Only randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies (RS) were included. We performed study selection, data extraction, and risk of bias assessment and meta-analyses with fixed and random effects models based on statistical heterogeneity. Data were combined using Review Manager software.

Results: In total, 388 articles were retrieved; 8 met our inclusion criteria: 4 RCTs, 1 CCT, and 3 RSs. Five of the included articles were analyzed regarding horizontal and vertical relapse. Although horizontal relapse was not significantly different between treatment options (P=0.65), vertical relapse was (P=0.03). Three and 2 studies were included in analyses of postoperative infections and of operation time; both showed significant differences between treatment options (P=0.0009 and P=0.006, respectively).

Conclusion: This analysis revealed lower incidence rates of vertical relapse and postoperative infections after BSSO, with the operation time also being significantly shorter. More high-quality RCTs are needed for a more reliable and convincing conclusion.


Keywords


bilateral sagittal split ramus osteotomy (BSSO); distraction osteogenesis (DO); relapse; postoperative infections; operating time; meta-analysis

References


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