A modified mandibular ramus osteotomy for orthognathic surgery

Abstract

Several procedures have been described for correction of orthognathic deformities of the mandible. Currently, the bilateral sagittal split osteotomy (BSSO) maintains its popularity because of its versatility and its amenability to rigid fixation techniques. The distal segment of the mandible can be repositioned in all planes of space, and the bony interface along the osteotomy results in predictable healing. However, there are well-known disadvantages to the procedure, which include neurosensory disturbance, 1 Pratt CA Labial sensory function following sagittal split osteotomy. Br J Oral Maxillofac Surg. 1996; 34: 75 Abstract Full Text PDF PubMed Scopus (43) Google Scholar , 2 Posnick J Alteration in facial sensibility in adolescents following sagittal split and chin osteotomies of the mandible. Plast Reconstr Surg. 1996; 97: 920 Crossref PubMed Scopus (67) Google Scholar , 3 Lemke RR Effects of hypesthesia on oral behaviors of the orthognathic surgery patient. J Oral Maxillofac Surg. 1998; 56: 153 Abstract Full Text PDF PubMed Scopus (26) Google Scholar , 4 Jacks SC A retrospective analysis of lingual nerve sensory changes after mandibular bilateral sagittal split osteotomy. J Oral Maxillofac Surg. 1998; 56: 700 Abstract Full Text PDF PubMed Scopus (50) Google Scholar , 5 Fujioka M Comparative study of inferior alveolar disturbance restoration after sagittal split osteotomy by means of bicortical versus monocortical osteosynthesis. Plast Reconstr Surg. 1998; 102: 37 Crossref PubMed Scopus (45) Google Scholar , 6 Blomqvist JE Sensibility following sagittal split osteotomy in the mandible: A prospective clinical study. Plast Reconstr Surg. 1998; 102: 325 Crossref PubMed Scopus (52) Google Scholar , 7 August M Neurosensory deficit and functional impairment after sagittal ramus osteotomy: A long-term follow-up study. J Oral Maxillofac Surg. 1998; 56: 1231 Abstract Full Text PDF PubMed Google Scholar , 8 Westermark A Inferior nerve function after mandibular osteotomies. Br J Oral Maxillofac Surg. 1998; 36: 425 Abstract Full Text PDF PubMed Scopus (174) Google Scholar , 9 Westermark A Inferior alveolar nerve function after sagittal split osteotomy of the mandible: Correlation with degree of intraoperative nerve encounter and other variables in 496 operations. Br J Oral Maxillofac Surg. 1998; 36: 429 Abstract Full Text PDF PubMed Scopus (139) Google Scholar condylar displacement, 10 Magalh-aes AE Changes in condylar position following bilateral sagittal split ramus osteotomy with setback. Int J Adult Ortho Orthognath Surg. 1995; 10: 137 PubMed Google Scholar , 11 Van Sickels JE Condylar torque as a possible cause of hypomobility after sagittal split osteotomy: Report of three cases. J Oral Maxillofac Surg. 1997; 55: 398 Abstract Full Text PDF PubMed Scopus (20) Google Scholar , 12 Nishimura A Positional changes in the mandibular condyle and amount of mouth opening after sagittal split ramus osteotomy with rigid or nonrigid osteosynthesis. J Oral Maxillofac Surg. 1997; 55: 672 Abstract Full Text PDF PubMed Scopus (33) Google Scholar , 13 Van Sickels JE Condylar position with rigid fixation versus wire osteosynthesis of a sagittal split advancement. J Oral Maxillofac Surg. 1999; 57: 31 Abstract Full Text PDF PubMed Scopus (32) Google Scholar and unfavorable splits. 14 Martis CS Complications of the mandibular sagittal split osteotomy. J Oral Maxillofac Surg. 1984; 42: 101 Abstract Full Text PDF PubMed Scopus (146) Google Scholar , 15 Van Sickels JE Jeter JE Theriot BA Management of an unfavorable lingual fracture during a sagittal split osteotomy. J Oral Maxillofac Surg. 1985; 43: 808 Abstract Full Text PDF PubMed Scopus (26) Google Scholar , 16 Turvey TA Intraoperative complications of sagittal osteotomy of the mandibular ramus: Incidence and management. J Oral Maxillofac Surg. 1985; 43: 504 Abstract Full Text PDF PubMed Scopus (104) Google Scholar , 17 Marquez IM Modification of the sagittal split osteotomy to avoid unfavorable fracture around impacted third molars. Int J Adult Ortho Orthognath Surg. 1998; 13: 183 PubMed Google Scholar