Does lifestyle modification (physical exercise and listening to music) improve symptoms in patients with a temporomandibular disorder? A randomized clinical trial.

Introduction: The aim of the study was to compare pain relief in temporomandibular disorder (TMD) patients with or without lifestyle modification. Materials and Methods: This randomized clinical trial was performed on patients with TMD, who did not regularly exercise or listen to music. The participants were allocated into two groups. In the treatment group, the participants were instructed to exercise five times or more per week (30 minutes per session) and listen to the music of their choice five times or more per week (15 minutes per session) for 12 weeks. In the control group, the participants had their usual lifestyle without any modifications. The participants were examined for clicking and crepitus in the joint and maximum mouth opening before and after the intervention. The pain severity was also documented based on a visual analog scale. Results: Thirty five patients were studied in each group. Twelve weeks after the intervention, the mean pain severity was 2.70 ± 0.73 in the treatment group and 4.63 ± 0.77 in the control group. The results of data analysis demonstrated a significant difference between the two groups regarding the mean pain severity at 12 weeks after the intervention (P <.001). Conclusions: Lifestyle modification through physical exercise and listening to music may reduce pain in TMD patients.

Impact of Osteoporosis on Autogenous Bone Graft Resorption.

BACKGROUND: Osteoporosis is a common disorder that is characterized by decreased bone density and increased bone resorption. This bone resorption may affect the grafted bone during the maxillofacial reconstruction. PURPOSE: This study aimed to measure the association between osteoporosis and resorption of anterior iliac crest bone grafts used to reconstruct the atrophic anterior maxillae. STUDY DESIGN, SETTING, SAMPLE: This prospective cohort study included female patients requiring bone augmentation of the anterior maxilla. Patients with a ridge width of <4 mm and ridge height of >7 mm were enrolled in the study. Exclusion criteria were chronic use of corticosteroids or intravenous bisphosphonates, history of maxillofacial radiation therapy, current smoking, and underlying conditions contributing to bone metabolism (eg, hyperparathyroidism, chronic renal failure, and hypophosphatemia). PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: Osteoporosis status was a predictor variable. Patients were allocated to the osteoporosis or control group based on T-scores obtained by dual-energy x-ray absorptiometry. Mean T-scores ≤ -2.5 were assigned to the osteoporosis group. MAIN OUTCOME VARIABLE(S): The outcome variable was graft resorption, defined as the difference in ridge width between measurements made immediately (T1) and 6 months postoperatively (T2) using cone-beam computed tomography. COVARIATES: Patient age, preoperative (T0) bone width, and the amount of bone augmentation, defined as the differences in ridge width between measurements made preoperatively (T0) and immediately after grafting (T1), were covariates of this study. ANALYSES: Descriptive, analytic, and general linear models were computed. Statistical significance was set a P < .05. RESULTS: Thirty-two patients were included in the study (15 in the osteoporosis group and 17 in the control group). The amount of graft resorption at 6 months after grafting was 2.57 ± 0.59 mm in the osteoporosis group and 0.97 ± 0.59 mm in the control group (P < .001). A significant correlation was found between the mean T-score and graft resorption 6 months after grafting (P < .001). CONCLUSION AND RELEVANCE: A significant correlation was observed between osteoporosis and graft resorption in the anterior maxilla after 6 months.

Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. MAIN TEXT: We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case-control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. CONCLUSIONS: Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.

Comparison of marginal bone loss in SLA and RBM implants: A prospective cohort study.

Context: The study aims to answer the following question: Among the patients who received a dental implant, is there any difference in marginal bone loss (MBL) between sandblasted and acid-etched (SLA) and resorbable blast media (RBM) implants? Aims: The study aimed to evaluate marginal bone loss in SLA and RBM implants one year after loading. Settings and Design: A Prospective Cohort Study. Methods and Material: In this prospective cohort study with a pre-protocol population, subjects were assigned into two groups: Subjects received SLA implants in group 1 and RBM in group 2. MBL was assessed 12 months after loadings through digital parallel radiographs. Statistical Analysis Used: An Independent t-test was used to compare MBL between the two groups. Results: Sixty-six implants were studied (each group 33 implants). The mean of MBL in the RBM group was significantly higher than the SLA group (1.39 ± 0.31 mm, 0.89 ± 0.26 mm, respectively, P < 0.001). MBL in the mesial sides of implants in the RBM group was significantly higher than the SLA group (1.28 ± 0.29 mm, 0.8 ± 0.29 mm, respectively, P < 0.001). Analysis of the data demonstrated a significantly higher mean of MBL in the distal sides of implants in the RBM group than in the SLA group (1.51 ± 0.35 mm, 0.97 ± 0.27 mm, respectively, P < 0.001). In both groups, the mean of MBL on the distal side was significantly higher than on the mesial side (P < 0.05). Conclusions: Within this study's limitation, RBM implants showed significantly more MBL than SLA implants.

Can topical phenytoin combined with tetracycline enhance the healing process in medication-related osteonecrosis of jaw? A comparative study.

Introduction: Treatment of Medication-related osteonecrosis of the jaw (MRONJ) is challenging. The aim of this study was to assess the effect of topical phenytoin on the healing process of MRONJ after debridement. Materials and Methods: In this study, patients with stage II of MRONJ were randomly allocated to two groups: Group 1 received debridement of the necrotic bone, with additional 5% topical phenytoin + tetracycline. Patients in group 2 underwent debridement and the involved area was primarily closed. Patients were evaluated after 1 (T1), 6 (T2), and 12 (T3) months. The presence of wound dehiscence (stage 0: No dehiscence, stage 1: Less than 10 mm dehiscence, stage 2: More than 10 mm dehiscence) and infection (presence or absence of pus and sinus tract) was evaluated. At the 12-month follow-up (T3), the number of patients who were asymptomatic for 3 months was documented in each group. Results: Twenty patients completed the study protocol (10 patients in each group). At T1 and T3, a significant difference was noted in the stage of healing between the two groups (P < 0.05). At T3, nine patients in group 1 and four patients in group 2 were symptom-free for 3 months. (P = 0.03). Conclusion: These results demonstrated that debridement combined with topical administration of phenytoin and tetracycline improved the healing process and relapse rate after treatment in stage II of MRONJ patients.

Does Caffeine Affect Dental Implant Stability? A Prospective Cohort Study.

Statement of the Problem: Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation. Purpose: This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients. Materials and Method: A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement. Results: A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p= 0.13, p= 0.36 and p= 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p=0.47, df=1, F=0.52). Conclusion: Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla.

Does maxillomandibular fixation affect skeletal stability following mandibular advancement? A single-blind clinical trial.

BACKGROUND: The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF). MATERIALS AND METHODS: A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups. RESULTS: Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively). CONCLUSION: According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.

Oral fixed drug eruption: Analyses of reported cases in the literature.

BACKGROUND: This analytic study aimed to summarize the data regarding OFDEs manifestations and characteristics available up to date. MATERIALS AND METHODS: We searched online databases for relevant articles and summarized their data regarding age, gender, Main drug classification and name, additional drugs, dosages, primary disorders, OFDE presentation and location, extra-oral presentation and location, follow-up, and treatment. RESULTS: The mean age of OFDE-affected patients was 38.9. Most of the reported cases were between 30 and 60 years of age. The female/male ratio was 1.12/1. Three drug classifications, which were mainly associated with OFDEs, were analgesics (27.8%), antibiotics (22.2%), and antifungals (11.1%). The most common additional drugs were oral contraceptives and corticosteroids. The three most prevalent disorders or conditions were infectious disease (23.7%), pain (13.2%) and auto-immune disease (10.5%). Erythematous lesions without blister (38.9%), lichenoid drug eruptions (16.7%), blisters/vesicles (13.9%) and ulcers (13.9%) were the most common manifestations of OFDEs. The rarest manifestation of OFDE was pigmentation. Lips, tongue, buccal mucosa, palate and gingiva were the sites in which OFDEs occurred in the included studies. Similar to OFDEs, erythematous lesions without blisters and lichenoid drug eruptions were the most prevalent extra-oral manifestations. The most common time for OFDE manifestations was one to three days after taking the drug. CONCLUSIONS: Due to the similarities between the reported cases of OFDEs, clinicians should familiarize themselves with OFDE cases in order to screen suspected patients effectively.

Effect of Local Injection of Lidocaine and Articaine plus Epinephrine on Methemoglobin Level during General Anesthesia.

Statement of the Problem: Methemoglobinemia is a potentially life-threatening rare medical condition, which refers to an increase in the level of oxidized form of hemoglobin (methemoglobin). Excessive replacement of hemoglobin with methemoglobin leads to functional hypoxia and even fatal conditions. Purpose: The aim of this study was to evaluate the effect of two common local anesthetic agents namely lidocaine and articaine administered for hemostasis during surgery on methemoglobin level. Materials and Method: This prospective cohort study was conducted from January 2017 to December 2019. Demographic data including age, gender, and weight of patients were collected. Sixty patients were randomly divided into three groups (n=20) regarding the local anesthetic agent administered for hemostasis during surgery as lidocaine group (group 1), articaine group (group 2), and control group (no local anesthetic; group 3). The patients were candidates for orthognathic surgery, reconstruction of the maxillary and mandibular atrophic ridges with autogenous grafts, and reconstruction of maxillofacial fractures. The methemoglobin level was measured before surgery and six hours after the initiation of surgery. Results: The mean age and weight of patients were not significantly different among the three groups (p= 0.891 and p= 0.416, respectively). No significant differences were observed among the three groups regarding the gender distribution (p= 0.343) or type of surgery (p= 0.990). Statistical analysis did not show any significant difference in the mean baseline methemoglobin level among the three groups (p= 0.109). Although the mean methemoglobin values increased in the three groups, paired sample t-test did not show any significant change in the values at six hours after the initiation of surgery compared with baseline in any of the three groups (p= 0.083 for group 1, p= 0.096 for group 2, and p= 0.104 for group 3). Conclusion: The results demonstrated that administration of lidocaine and articaine plus epinephrine for hemostasis during general anesthesia are equally safe.

Are olfactory and gustatory symptoms useful at predicting disease severity markers in COVID-19 infection?

Context: The relationship between olfactory and gustatory dysfunction (OGD) and COVID-19 infection severity is still unclear. Aim: To investigate the correlation between OGD in COVID-19-infected individuals and RT-PCR results, chest CT scan abnormality, lymphocyte counts, hospital admission units, age, body temperature, and blood oxygen saturation. Setting and Design: Case-control study. Materials and Methods: The sample was composed of laboratory and chest X-ray confirmed COVID-19-infected patients from four hospitals. The patients were divided into case and control groups based on the presence of OGD symptoms. The predictor variable was OGD. The outcome variable was gender, hospital admission unit, chest CT scan abnormality, PCR, lymphocyte counts, age, body temperature, and blood oxygen saturation. Statistical Analysis Used: Bivariate statistics were computed and the P value was set at 0.05. Results: The sample consisted of 189 patients. Smell and taste disorders were found in 31.7% and 24.3% of patients, respectively. OGD was significantly correlated with positive PCR results (P < 0.001) and general unit admission (P < 0.05) during hospitalization. Additionally, patients with OGD had significantly lower mean age (P < 0.001), higher body temperature (P < 0.01), and blood oxygen saturation (P < 0.01). However, OGD was not correlated with gender, chest CT scan abnormality, or lymphocyte counts (P > 0.05). Conclusions: OGD symptoms can be used to detect COVID-19-infected patients. OGD can be used to predict less severe disease mainly by its correlation with the less amount of hospital care, more negative PCR results, higher body temperature, and higher blood oxygen saturation.

Does Bruxism Affect Marginal Bone Level around Single Tooth Implants in the Posterior Mandible?

Background: Parafunctional forces are a potential risk factor for implant-related complications. This study aimed to evaluate the possible relationship of bruxism with implant-related complications and marginal bone loss (MBL). Methods: In this prospective cohort study, patients were divided into two groups with and without bruxism, and received single-tooth implants in the posterior mandible. Patients in the bruxer group were requested to use a customized fabricated night guard. Bone quality was also assessed based on CBCT scans. The MBL, crown detachment, and porcelain fracture were evaluated, and clinical assessments were made at the 12-month follow-up. Results: Seventy patients were studied in two groups (n = 35 in each group). None of the implants in any of the two groups showed pain, sensitivity, suppuration, exudation, clinically detectable mobility, or peri-implant radiolucency. No significant difference was observed between the two groups in the mean MBL at the 12-month follow-up (p = 0.60). Regarding bone quality, there was no significant difference in the mean MBL among different types of bone qualities (p = 0.66). There were no significant differences regarding crown detachment and porcelain fracture between the two groups either (p = 0.32 and p = 0.30, respectively). Conclusion: According to the results of this study, dental implant treatment according to the suggested protocol in bruxers yielded promising outcomes.

Intraoral transnasal approach for surgical extraction of bilateral deeply impacted mesiodens: A case report.

We describe a novel modified intranasal approach to minimize the complications of the impacted mesiodens surgical extraction. Also, it can be performed under local anesthesia with proper preoperative workup.

Does P16 Protein Expression Affect Treatment Prognosis in Oral Squamous Cell Carcinoma - A Comparative Study.

INTRODUCTION: P16 is an independent and reliable surrogate for the detection of human papillomavirus (HPV) in oral squamous cell carcinoma (OSCC). The aim of this study was to assess the P16 expression as a marker for HPV infection in OSCC and its impact on the treatment outcome. METHODS AND MATERIALS: A cross-sectional study was conducted on patients with a definite diagnosis of OSCC. Patients were assigned into two groups with and without recurrence or metastasis. Tumour resection was performed in the same manner for all patients. P16 expression was evaluated by immunohistochemical staining. Independent t-test and Chi-square tests were used to find significant differences in age, gender, stage of the disease, tumour size, lymph node involvement, and P16 expression between the two groups. RESULTS: Of 50 patients, 37 did not show any recurrence or metastasis (group 1), while 13 had a relapse (group 2). There was no significant difference for age, gender distribution, stage of the disease, or lymph node involvement between the two groups (P > 0.05). A significant difference in tumour size was noted between the two groups (P = 0.001). The mean expression of P16 was 38.92 ± 24.36 in group 1 and 51.54 ± 33.63 in group 2. No significant difference was found between the two groups for the mean expression of P16 (P = 0.23). DISCUSSION: A review of the recent literature revealed that the HPV role in OSCC treatment is controversial. According to the results of this study, there was no significant difference in terms of P16 expression between OSCC patients with and without recurrence or metastasis.

Drug-related cancers: Analyses of head and neck cases reported in the literature.

BACKGROUND: Recent advances have attributed carcinogenic potential to pharmacotherapy. Cancers of the head and neck region are no exception. OBJECTIVES: This descriptive investigation aimed to identify studies reporting on drugs that have contributed to cancer development in the head and neck region. MATERIAL AND METHODS: Online databases were searched for relevant articles and their data were summarized, including age, gender, main drug classification and name, additional drugs, primary disorders, drug-related cancers, and the site of each drug-related cancer. RESULTS: The mean age of the patients included in this analysis was 52.9 years. However, drug-related head and neck cancers (DR HNCs) were most prevalent in persons over 60 years of age. Overall, these cancers were more prevalent in females than in males (1.33/1). The HNC-related drugs could mainly be categorized into 3 groups, namely, immunomodulatory/immunosuppressive, chemotherapeutic and chemoprotective drugs, while the most frequently used additional drugs across the studies were corticosteroids. The 5 most prevalent primary conditions for which the patients had received pharmacotherapy were organ transplantations, lymphoproliferative disorders (LPD), rheumatoid arthritis (RA), Epstein-Barr virus (EBV) infection, and bone sarcoma. The most prevalent HNCs were squamous cell carcinoma (SCCs), thyroid cancers (including papillary and follicular thyroid carcinomas), LPD, and mucoepidermoid/acinic cell carcinomas, which occurred mostly in the oral cavity, neck, salivary glands, pharynx/larynx, and head/face. CONCLUSIONS: This study was the first of its kind to analyze and discuss the aforementioned findings regarding the head and neck region in depth. Clinicians should familiarize themselves with DR HNC cases to effectively screen suspected patients.

Juvenile trabecular ossifying fibroma of the maxilla: Case report of a diagnostic dilemma.

Ossifying fibromas (OFs) are benign, well-demarcated lesions in the craniofacial region, particularly in the jaws, with clinical, radiographic, and histopathological similarities to other lesions, which make their diagnosis challenging. Herein, we report a case of a fibro-osseous lesion in the anterior maxilla of a 13-year-old boy, consisting of an intraosseous and an extra-osseous part, which created a diagnostic dilemma.

Do Patients have the Same Experience of Pain Following Tooth Extraction and Dental Implants?

INTRODUCTION: Postoperative pain is an important concern for patients who need dental implants. This study aims to compare the experience of pain in patients who undergo tooth removal and dental implant surgery. MATERIALS AND METHODS: This is a crossover study. Patients who underwent a simple tooth extraction and dental implant surgery were studied. The pain severity was assessed using a visual analog scale at 12, 24, 48, and 72 h after procedures. The repeated measure test was used to compare pain severity between two treatment sessions. RESULTS: Forty patients were studied. Patients reported higher pain levels in a tooth extraction at study times than implant surgery (P = 0.001). CONCLUSION: It seems patients who had experience of tooth extraction and a dental implant placement reported significantly lower pain in implant surgery.

Can Low-Level Laser and Light-Emitting Diode Enhance the Stability of Dental Implants?

PURPOSE: Stability of dental implants is an important factor for evaluation of osseointegration. The aim of this study was to evaluate the effect of combined use of low-level laser (LLL) and light-emitting diode (LED) therapy on the stability of dental implants during the healing phase. MATERIALS AND METHODS: This was a randomized clinical trial. Patients were assigned to two groups: In group 1, patients received LLL and LED 20 min/day for 10 days after implant insertion. Patients in group 2 (controls) did not undergo LLL and LED. The implant stability quotient (ISQ) was measured at 0 (time 0), 10 (time 1), 21 (time 2), 42 (time 3) and 63 days (time 4) after implant placement. Independent t test was used to compare the ISQs between the two groups. RESULTS: Fifty-eight patients were studied in two groups (n = 28). The mean ISQ did not differ immediately after insertion (P > 0.05). The mean ISQ differed significantly between the two groups on days 10, 21, 42 and 63 (P < 0.05). Results demonstrated an increase in the amount of ISQ in group 1 (intervention) at times 1, 2, 3 and 4. In the control group, the amount of ISQ decreased on days 10 and 21 following implant insertion, but increased afterward on days 42 and 63. CONCLUSION: The results of this study showed that simultaneous use of LLL and LED increased the stability of the implants after 9 weeks of follow-up.

Drug-related Dysgeusia: A Systematic Review.

PURPOSE: Dysgeusia is an unpleasant alteration in taste. It can affect the nutritional and psychological status and decrease the quality of life of patients. It may be caused by nerve injury, head and neck trauma or surgery, infections, radiotherapy and drugs, but certain aetiological factors have not yet been identified. Understanding dysgeusia as a drug side effect is important for practitioners. The aim of this systematic review was to provide detailed information about dysgeusia in patients receiving different common medications. MATERIALS AND METHODS: An electronic search was conducted in MEDLINE, Google Scholar and Scopus databases, and studies were selected according to our inclusion criteria. We included studies on human subjects that reported dysgeusia as a drug side effect. RESULTS: Thirty-four eligible studies were included in the systematic review. Thirty-five drugs were found in the literature to be correlated to dysgeusia. The most commonly reported offending drugs were from keratolytic agents, chemotherapeutic and cancer medication, antihistamine, antibiotics and angiotensin-converting enzyme inhibitors. CONCLUSION: The quality of evidence was low in most reviewed studies. More studies with standard methodology are needed in this field. However, physicians and dental practitioners must consider the probability of dysgeusia as an adverse side effect when prescribing certain medications.

Can Use of Rigid Fixation After Consolidation Increase Stability in Cleft Patients Following Distraction Osteogenesis?

PURPOSE: The stability of distraction osteogenesis (DO) is an important issue in maxillary advancement for patients with cleft lip and palate (CLP). The aim of this study was to evaluate postoperative stability in patients with and without internal fixation after removing maxillary distraction devices. MATERIALS AND METHODS: This randomized clinical trial assessed patients with CLP who needed maxillary advancement greater than 6 mm; they were randomly assigned to 1 of 2 groups. In group 1, distraction devices were removed 3 months after distraction and then 4 L miniplates were placed bilaterally in the maxilla. In group 2 (controls), no miniplates were placed after removing the distraction devices. Lateral cephalograms taken on 3 occasions (preoperatively, immediately after removing the distraction device, and after 18 months) were used to determine vertical and horizontal changes at the A point. RESULTS: Twenty-two patients (n = 11 per group) were included. There was no significant difference between groups for horizontal relapse (P = .79). The results showed no significant difference for vertical relapse between the 2 groups (P = .11). The Pearson correlation test showed a correlation between the amount of advancement and horizontal relapse at the A point in group 1 (P = .01) and group 2 (P = .001). In group 1, for every 1-mm maxillary advancement, a 0.36-mm relapse was seen (B = 0.36, P = .01). In group 2, for every 1-mm maxillary advancement, a 0.43-mm relapse was seen (B = 0.43, P = .001). CONCLUSION: According to these results, rigid fixation after consolidation did not increase stability in patients with CLP after DO.