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.