Abstract
Sagittal split ramus osteotomy has been used to remove deeply impacted mandibular third molars. 1 Jones T.A. Garg T. Monaghan A. Removal of a deeply impacted mandibular third molar through a sagittal split ramus osteotomy approach. Br J Oral Maxillofac Surg. 2004; 42: 365-368 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar , 2 Amin M. Haria S. Bounds G. Surgical access to an impacted lower third molar by sagittal splitting of the mandible: a case report. Dent Update. 1995; 22: 206-208 PubMed Google Scholar , 3 Toffanin A. Zupi A. Cicognini A. Sagittal split osteotomy in removal of impacted third molar. J Oral Maxillofac Surg. 2003; 61: 638-640 Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar The main disadvantages of conventional operations for such teeth are the extent of bone removed, limited visibility, 1 Jones T.A. Garg T. Monaghan A. Removal of a deeply impacted mandibular third molar through a sagittal split ramus osteotomy approach. Br J Oral Maxillofac Surg. 2004; 42: 365-368 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar high risk of injury to the inferior alveolar nerve, and fracture of the mandible. 2 Amin M. Haria S. Bounds G. Surgical access to an impacted lower third molar by sagittal splitting of the mandible: a case report. Dent Update. 1995; 22: 206-208 PubMed Google Scholar In comparison, sagittal split ramus osteotomy gives good access, conserves bone that would otherwise have been removed, and allows the nerve to be seen and avoided. 1 Jones T.A. Garg T. Monaghan A. Removal of a deeply impacted mandibular third molar through a sagittal split ramus osteotomy approach. Br J Oral Maxillofac Surg. 2004; 42: 365-368 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar , 2 Amin M. Haria S. Bounds G. Surgical access to an impacted lower third molar by sagittal splitting of the mandible: a case report. Dent Update. 1995; 22: 206-208 PubMed Google Scholar , 3 Toffanin A. Zupi A. Cicognini A. Sagittal split osteotomy in removal of impacted third molar. J Oral Maxillofac Surg. 2003; 61: 638-640 Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar However, the osteotomy puts the occlusion at risk (although this is rare) and there is a risk of an unfavourable split in either the proximal or distal segment (2%). 4 Mehra P. Castro V. Freitas R.Z. Wolford L.M. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars. J Oral Maxillofac Surg. 2001; 59: 854-858 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar This is about twice as high if the third molar is impacted. 4 Mehra P. Castro V. Freitas R.Z. Wolford L.M. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars. J Oral Maxillofac Surg. 2001; 59: 854-858 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar The published incidence of disturbance of the inferior alveolar nerve is high: as much as 58% at 6 months, and 35% at 1 year postoperatively.
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