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Modified Mandibular Inferior Border Sagittal Split Osteotomy Reduces Postoperative Risk for Developing Inferior

Jimoh Olubanwo Agbaje1, Bert Gemels2, Ahmed S Salem3

  • 1Postdoctoral Fellow, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|February 7, 2016
PubMed
Summary

A modified sagittal split osteotomy (SSO) technique significantly reduces inferior border defects. Surgeons should avoid including the inferior border cortex in the split and consider bone grafting for advancements over 10 mm or patients over 30 years old.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Surgical Anatomy

Background:

  • Inferior border defects are a known complication of sagittal split osteotomy (SSO).
  • Identifying risk factors and refining surgical techniques are crucial for improving outcomes in orthognathic surgery.

Purpose of the Study:

  • To assess the efficacy of a modified SSO technique in minimizing persisting inferior border defects.
  • To determine patient-specific and surgical factors associated with the occurrence of these defects.

Main Methods:

  • Retrospective analysis of 276 patients undergoing bilateral SSO by a single surgeon.
  • Radiographic evaluation of 408 operation sites to identify inferior border defects.
  • Statistical analysis of age and length of mandibular advancement as predictor variables.

Main Results:

  • A 5.1% incidence of osseous defects at the inferior border was observed.
  • Advanced patient age and greater length of mandibular advancement were significant risk factors for defect development.
  • The modified SSO technique was associated with a lower frequency of these defects.

Conclusions:

  • The modified inferior border osteotomy technique in SSO substantially lowers the frequency of persisting inferior border defects.
  • Surgeons should avoid splitting the lingual cortex of the inferior border.
  • Consider bone grafting for advancements >10 mm or patients >30 years old to mitigate defect risk.