We retrospectively evaluated the results of mandibular setback by sagittal splitting ramus osteotomy performed by our department between 1989 at 2005. Two hundred-one patients were grouped into three categories; nonrigid fixation using intraosseous wiring with a mean intermaxillary fixation (IMF) period of 38.9 days (52 cases), rigid fixation consisting of positioning screw (18 cases, mean IMF period; 21.7 days) and mini-plate (131 cases, mean IMF period; 21.4 days) were reviewed. Regarding functional disturbance after surgery, a higher incidence of neurosensory deficiencies of mental nerve and TMJ disorders were observed in cases in which positioning screw or mini-plate were used, in comparison with wire osteosynthesis cases. To determine skeletal relapse within 12 months after surgery, lateral cephalograms were employed for cases in which the amount of R-, L- set back differences were less than 3mm. The relapse was minimal in positioning screw cases, while the mini-plate fixation showed a greater amount of relapse compared to wire fixation, suggesting that three-dimensional repositioning of temporomandibular joint and longer term intermaxillary fixation were useful to obtain skeletal stability.