Selection of sagittal split ramus osteotomy technique based on skeletal anatomy and planned distal segment movement: Current therapy

Abstract

The most common osteotomy of the mandible for the correction of dentofacial deformities is the sagittal split ramus osteotomy (SSRO). Trauner and Obwegeser 1 Trauner R. Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration for genioplasty. Oral Surg Oral Med Oral Pathol. 1957; 10: 677 Abstract Full Text PDF PubMed Scopus (650) Google Scholar popularized this technique in 1957 for correction of prognathism and retrognathism. They developed a technique for performing an SSRO that involved extensive soft tissue dissection and a horizontal corticotomy on the medial and lateral aspects in the vertical ramus to the posterior border. They found that this technique provided good contact of wide cancellous bone surfaces that resulted in quick bony union. However, there are complications inherent in this technique, including excessive swelling and bleeding, intraoperative trauma to the temporomandibular joint, damage to the inferior alveolar nerve (IAN), and unfavorable fractures of the proximal and/or distal segments of the mandible. Unfavorable fractures can result in infection, sequestration of fragments, delayed union, malunion, or fibrous union of the osteotomy sites.