{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T17:27:39Z","timestamp":1771262859883,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to evaluate postoperative craniocervical changes after bilateral sagittal split ramus osteotomy (BSSRO), to test mandibular translation and rotation as predictors, and to explore their coupling with tongue and hyoid adaptations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 210 patients (88 males, 122 females; 18\u201358 years) were equally divided into skeletal Classes I\u2013III. Cephalograms in natural head posture were obtained pre- and postoperatively. Craniocervical change (\u0394NSL\/OPT) was the primary outcome. Mandibular translation (\u0394Go\u2013Me) and rotation (\u0394FH\u2013MP) served as predictors, with tongue and hyoid variables as secondary outcomes. Reliability was assessed using intraclass correlation coefficients (ICCs). Statistical analyses included analysis of variance (ANOVA), correlation, and multivariable regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Measurement reproducibility was excellent (ICC &amp;gt; 0.92). Mandibular advancement (Class II) and setback (Class III) produced class-specific changes in \u0394Go\u2013Me and \u0394FH\u2013MP. Postoperatively, Class II showed cervical flexion (\u22123.09\u00b0\u202f\u00b1\u202f7.12\u00b0) whereas Class III showed cervical extension (+2.92\u00b0\u202f\u00b1\u202f5.48\u00b0, P &amp;lt; .001). \u0394NSL\/OPT correlated with \u0394FH\u2013MP (r = 0.25, P = .002) and \u0394Go\u2013Me (r = 0.17, P = .017), though only \u0394FH\u2013MP remained significant in regression (\u03b2 \u2248 0.47\u00b0 per 1\u00b0 rotation). \u0394NSL\/OPT was most strongly correlated with \u0394SNH (r = 0.62, P &amp;lt; .001), indicating coordinated craniocervical\u2013hyoid adaptation. Tongue showed modest lengthening, flattening, and anterior shift across both advancement and setback groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cervical extension after BSSRO is primarily driven by mandibular rotation rather than translation, underscoring the clinical importance of incorporating rotational vectors into surgical planning. Coupled tongue\u2013hyoid adaptations reflect early neuromuscular compensation, with potential implications for long-term stability and functional outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejo\/cjaf111","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:43:30Z","timestamp":1765889010000},"source":"Crossref","is-referenced-by-count":0,"title":["Postoperative craniocervical change after bilateral sagittal split ramus osteotomy in Classes II and III: predictive role of mandibular rotation and tongue\u2013hyoid coupling"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-4678","authenticated-orcid":false,"given":"Boosana","family":"Kaboosaya","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University , Wangmai, Pathum Wan, Bangkok 10330 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