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Related Experiment Video

Updated: Jun 13, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Occurrence of bad splits during sagittal split osteotomy.

Bart Falter1, Serge Schepers, Luc Vrielinck

  • 1Oral and Maxillofacial Surgery, St. John's Hospital, Genk, Belgium.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|May 11, 2010
PubMed
Summary

Bad splits, defined as buccal or lingual plate fractures during sagittal split osteotomies (SSOs), occurred at a low incidence of 0.7%. Surgical experience and technical advancements did not significantly reduce this complication over 20 years.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Surgical Complications

Background:

  • Sagittal split osteotomy (SSO) is a common procedure in orthognathic surgery.
  • Bad splits, characterized by buccal or lingual plate fractures, are a known complication of SSO.
  • Understanding the incidence and risk factors for bad splits is crucial for improving surgical outcomes.

Purpose of the Study:

  • To determine the incidence of bad splits in sagittal split osteotomies (SSOs).
  • To investigate whether the occurrence of bad splits decreased over time due to technical progress or surgical experience.

Main Methods:

  • Retrospective review of 1008 patients undergoing SSO between October 1989 and October 2009.
  • Analysis of 2005 SSO sites to identify and quantify bad splits.

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Last Updated: Jun 13, 2026

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  • Correlation of bad splits with patient age, type of deformity, and skeletal class.

    • Main Results:

    • A bad split occurred in 14 of 2005 SSO sites (0.7% incidence).
    • No significant decrease in bad split incidence was observed over the 20-year study period.
    • Bad splits were managed perioperatively with plate osteosynthesis, resulting in good functional occlusion and no infections.
    • No correlation was found between bad splits and patient age, dental-facial deformity, or skeletal class.

    Conclusions:

    • Bad splits are an infrequent but possible complication of mandibular SSO.
    • The incidence of bad splits remained consistent over 20 years, unaffected by technical advancements or surgeon experience.
    • This complication is manageable with a low rate of adverse outcomes.