Associate Professor of Oral and Maxillofacial Surgery Vanderbilt University Medical Center Nashville, Tennessee
Synopsis : Intraoral vertical ramus osteotomy (IVRO) is a simple but useful technique that allows for mandibular setback, minor advancement, and various rotational movements. Traditionally, IVRO has been accomplished without internal fixation which necessitates a period of maxillomandibular fixation (MMF). The use of MMF in IVRO is the principal disadvantage of this technique and a source of patient discomfort, anxiety, and potential airway compromise. With recent advances in the development of anatomically correct surgical cutting guides, and the availability of the right-angle instrumentation, IVRO with internal fixation has been routinely performed at Vanderbilt University Medical Center since 2018. With the use of internal fixation, we have been able to avoid the use of MMF after IVRO.
The purposes of this breaking topic session include: 1) providing the audience with a clear understanding of the indications, advantages and limitations of this surgical technique, 2) utilizing virtual surgical planning to determine the feasibility of this technique, 3) sharing the recent instrumentation advances in IVRO, and 4) providing step-by-step instructions in performing IVRO with internal fixation.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
have a clear understanding of the indications, advantages and limitations of intraoral vertical ramus osteotomy (IVRO).
determine the feasibility of the IVRO technique during virtual surgical planning (VSP) and apply appropriate patient selection criteria to achieve the desired surgical outcome.
use the anatomically correct IVRO cutting guides to safely perform IVRO based on the location of the mandibular lingula in relation to the posterior ramus.
understand the surgical steps in performing IVRO with internal fixation
