COMPARATIVE EVALUATION OF DISTRACTION OSTEOGENESIS AND ORTHOGNATHIC SURGERY IN CORRECTION OF SEVERE MANDIBULAR DEFICIENCY

Background:Severe mandibular deficiency presents significant functional and esthetic challenges, often requiring
surgical correction. Orthognathic surgery (OS) has long been the conventional treatment, while distraction osteogenesis (DO) has emerged as an alternative offering gradual skeletal and soft-tissue adaptation. This study aimed to compare DO and OS in terms of skeletal stability, occlusal correction, airway improvement, esthetic outcomes, and postoperative complications.
Materials and Methods:A prospective comparative study was conducted on 60 patients with severe mandibular
deficiency, divided equally into two groups: Group I (n=30) underwent DO and Group II (n=30) underwent OS.
Preoperative and postoperative assessments included cephalometric analysis, occlusal evaluation, airway measurements, esthetic satisfaction surveys, and complication records. Patients were followed up at 6 and 12 months postoperatively.
Data were analyzed using SPSS software with significance set at p<0.05.
Results:Both groups achieved comparable mandibular advancements (~10 mm) and occlusal corrections. DO
demonstrated significantly lower relapse at 12 months (0.9 mm vs. 2.4 mm; p<0.001) and greater airway improvement (55.2 mm² vs. 41.8 mm²; p=0.002). Esthetic satisfaction was slightly higher in the OS group, though not statistically significant. DO was associated with more device-related complications, while OS had higher rates of relapse and neurosensory disturbances.
Conclusion:Both DO and OS are effective in correcting severe mandibular deficiency. DO offers superior skeletal
stability and airway benefits, whereas OS provides immediate esthetic outcomes with a shorter treatment duration.
Treatment choice should be individualized based on the extent of deficiency, airway considerations, and patient-specific needs.