The intermediate length BSSO: Finding the balance between the classical and short designs

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Skeletal Biology

Background:

• Dento-skeletal malformations often require orthognathic surgery for correction.
• Bilateral Sagittal Split Osteotomy (BSSO) is a common procedure in orthognathic surgery.
• Existing BSSO techniques may have limitations in achieving all desired orthognathic movements.

Purpose of the Study:

• To introduce and describe a novel, shorter variant of the Bilateral Sagittal Split Osteotomy (BSSO).
• To demonstrate that this BSSO variant facilitates all necessary orthognathic movements.
• To highlight the anatomical advantages and potential adjunctive procedures associated with this technique.

Main Methods:

• Development of a modified BSSO osteotomy line.
• Surgical execution of the shorter BSSO variant.
• Evaluation of the osteotomy's ability to achieve comprehensive orthognathic movements.
• Assessment of the preservation of the basilar rim and modification of mandibular angles.
• Consideration of concurrent Chin Wing genioplasty.

Main Results:

• The shorter BSSO variant successfully allows for all orthognathic movements.
• This technique respects the basilar rim, a critical anatomical landmark.
• The osteotomy line permits modification of the mandibular angles.
• The mandibular splitting occurs more naturally, separating the rising and horizontal branches.
• The technique is compatible with Chin Wing genioplasty.

Conclusions:

• The presented shorter BSSO variant is an effective modification for orthognathic surgery.
• This technique offers improved anatomical control and functional outcomes.
• It provides a versatile approach for correcting dento-skeletal malformations, potentially enhancing aesthetic results with genioplasty.