Abstract
BackgroundMandibular Sagittal Split Osteotomy (MSSO) is a popular technique in orthognathic surgery used both to advance and to retreat the mandible. However, MSSO may incur in important complications, such as bad splits and sensorineural injuries. Knowing the location of the fusion between the buccal and lingual cortical (FBLC) in the mandibular ramus and the bone thickness in the region where osteotomies will be performed is determinant in MSSO planning to avoid complications. The aim of this study was to document and evaluate possible differences between sexes regarding the location of the FBLC in relation to the superior cortical of mandibular foramen (MF) and bone thickness in the region of interest for MSSO in a Brazilian population.Material and MethodsEighty five cone-beam Computed Tomography (CBCT) scans were used to perform linear measurements to determine the location of the FBLC. Bone thickness from the mandibular canal (MC) to the cortical external surfaces and the diameter of the MC were measured at three different points: mandibular ramus (A), mandibular angle (B) and mesial of the second molar (C).ResultsThe FBLC was located at a mean distance of 8.3 mm from the superior cortical of the MF in males and 8.1 mm in females. There was no difference between males and females regarding the mean bone thickness from the MC to the buccal external surface at all the points investigated (p >>0.05). Bone thickness from the lingual external surface to the MC was bigger among females than males in regions B and C (p<0.05). The diameter of the MC was bigger among males in regions B and C.ConclusionsSexual dimorphism regarding mandibular bone thickness but not regarding the location of FBLC was present. This fundamental knowledge may assist to the panning of MSSO. Key words:Cone-Beam Computed Tomography, mandibular nerve, orthognathic surgery, sagittal split ramus osteotomy.
Highlights
Mandibular sagittal split osteotomy (MSSO) is one of the most common surgical procedures used in orthognathic surgery to correct dentofacial skeletal abnormalities
The bone thickness between the superior cortical and the mandibular canal (MC) was higher in males than in females (17.2 mm and 16.2 mm, respectively; p = 0.019) in Region C, and there was no difference in Region B (p = 0.403)
There are important complications that can compromise the success of this surgical procedure, such as injury to the inferior alveolar nerve (IAN) and the occurrence of bad splits [20,21,22]
Summary
Mandibular sagittal split osteotomy (MSSO) is one of the most common surgical procedures used in orthognathic surgery to correct dentofacial skeletal abnormalities. Bad splits may lead to infections; kidnappings of bone fragments; retardation of bone healing; nonunion, postoperative instability; and dysfunction in the temporomandibular joint Such complications can negatively affect the recovery and daily life of patients submitted to orthognathic surgery [8,9,10]. Knowing the location of the fusion between the buccal and lingual cortical (FBLC) in the mandibular ramus and the bone thickness in the region where osteotomies will be performed is determinant in MSSO planning to avoid complications. The aim of this study was to document and evaluate possible differences between sexes regarding the location of the FBLC in relation to the superior cortical of mandibular foramen (MF) and bone thickness in the region of interest for MSSO in a Brazilian population. This fundamental knowledge may assist to the panning of MSSO
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