Bone grafting in sagittal split ramus osteotomy as part of maxillomandibular advancement surgery in obstructive sleep apnea patients: A retrospective cohort study

Objective To evaluate the association of bone grafting with complications and skeletal stability following bilateral sagittal split osteotomy during maxillomandibular advancement (MMA) surgery for OSA.Methods This retrospective exploratory cohort study compared xenogeneic bone grafting (Bio-Oss® collagen, n = 20). Outcomes included mandibular border defects, postoperative skeletal relapse, surgical-site infection, and osteosynthesis material removal.Results Use of xenogeneic bone grafts was associated with lower odds of mandibular border defects compared with non-grafting (P = 0.022), whereas use of AIC bone grafts did not show significant differences in odds compared with non-grafting. (P = 0.259). Neither grafting method was significantly associated with postoperative skeletal relapse, surgical-site infection, or osteosynthesis material removal compared with controls.Conclusion Xenogeneic grafting was associated with fewer mandibular border defects following MMA surgery. Neither xenogeneic nor AIC grafting was associated with skeletal relapse, surgical-site infection, or osteosynthesis material removal.