[A PhD completed. Bilateral sagittal split osteotomy: risk factors for complications and predictability of the...

Bilateral sagittal split osteotomy (BSSO) is a surgical technique to correct hypoplasia, hyperplasia or asymmetry of the mandible. The risk of complications associated with BSSO with splitter and separators, the so-called splitter-separator technique, and the predictability of this technique were analysed. The average incidence of complications associated with classic BSSO techniques was determined by a review of the literature. With classic techniques, a bad split occurred in 2.3% of the operated sides, removal of osteosynthesis material on account of complaints in 11.2% of patients, and permanent neurosensory disturbances in the area of the mental nerve in 33.9% of patients. The incidence of complications for BSSO with splitter and separators is a bad split in 2.0% of the operated sides, necessary removal of osteosynthesis material in 5.6% of patients, and permanent neurosensory disturbances of the lower lip in 9.9% of patients. Removal of the third molars during BSSO may result in an increased chance of bad split but does not increase the risk of other complications. In conclusion, BSSO with splitter and separators is a reliable technique, with a remarkably low incidence of permanent neurosensory disturbances of the lower lip.