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Updated: Feb 9, 2026
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Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation
Robert Köhnke1, Andreas Kolk2, Lan Kluwe3
1Resident, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oral and Maxillofacial Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
Summary
Piezosurgery significantly reduces bilateral sagittal split osteotomy (BSSO) duration compared to conventional methods. However, it offers no improved protection against inferior alveolar nerve (IAN) injury or altered recovery.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Technology
- Neurosurgery
Background:
- Bilateral sagittal split osteotomy (BSSO) is a common procedure in orthognathic surgery.
- Inferior alveolar nerve (IAN) injury is a significant risk associated with BSSO.
- Piezosurgery offers a potential alternative to conventional osteotomy techniques.
Purpose of the Study:
- To compare the duration of piezosurgery versus conventional osteotomy for BSSO.
- To evaluate the impact of piezosurgery on inferior alveolar nerve (IAN) perturbation during BSSO.
Main Methods:
- Prospective randomized study of 100 BSSO procedures in 50 patients.
- Piezoelectric and conventional osteotomies performed on contralateral sides of the mandible.
- Procedure duration and intraoperative IAN status recorded.
- IAN neurosensory function assessed using two-point discrimination and static light touch.
Main Results:
- Piezosurgery group demonstrated significantly shorter mean osteotomy duration (17 vs 25 minutes).
- Intraoperative IAN exposure rates were similar between groups (68% vs 81%).
- No significant difference in IAN neurosensory disturbance or recovery was observed.
Conclusions:
- Piezosurgery is a faster method for performing BSSO compared to conventional osteotomy.
- Piezosurgery does not provide a demonstrable advantage in preventing IAN injury or improving recovery.
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