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How does bone thickness affect the split pattern of sagittal ramus osteotomy?

G Cunha1, M R Oliveira1, F S Salmen2

  • 1Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil.

International Journal of Oral and Maxillofacial Surgery
|June 27, 2019
PubMed
Summary
This summary is machine-generated.

Mandibular bone thickness impacts sagittal ramus osteotomy split patterns. Thinner bone, particularly at measurement A, correlates with unfavorable split types, suggesting a need to consider bone dimensions in surgical planning.

Keywords:
bilateral sagittal split osteotomycomputed tomographymaxillofacial surgeryorthognathic surgery

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Anatomical Studies

Background:

  • Sagittal ramus osteotomy is a common procedure in orthognathic surgery.
  • Split pattern variations can lead to complications and affect surgical outcomes.
  • The influence of mandibular bone thickness on these split patterns requires further investigation.

Purpose of the Study:

  • To investigate the relationship between mandibular bone thickness and sagittal ramus osteotomy split patterns.
  • To identify specific bone thickness measurements associated with different split types.

Main Methods:

  • Sixty-two sagittal ramus osteotomies were analyzed using Dolphin 3D software.
  • Four preoperative bone thickness measurements (A, B, C, D) were recorded.
  • Postoperative 3D images classified split patterns (Type I-IV) based on Plooij et al. classification.
  • Statistical analysis included Kruskal-Wallis and Dunn post-hoc tests.

Main Results:

  • A total of 62 splits were classified: 35 Type I, 1 Type II, 19 Type III, 7 Type IV.
  • Type I splits (most favorable) were associated with greater bone thickness, while Type IV (least favorable) had the lowest.
  • A statistically significant difference in thickness was found for measurement A between Type I and Type IV splits.

Conclusions:

  • Mandibular bone thickness is a significant factor influencing sagittal ramus osteotomy split patterns.
  • Thinner mandibular rami are more susceptible to unfavorable split patterns (e.g., Type IV).
  • Preoperative assessment of bone thickness may aid in predicting and potentially mitigating split pattern complications.