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Are There Differences in Fracture Patterns in Mandibular Ramus Sagittal Osteotomies Between Hunsuck/Epker, Wolford,
Jéferson Martins Pereira Lucena Franco1, Ivo Cavalcante Pita Neto2, Jamile de Melo Casado Pereira3
1Professor, Division of Oral and Maxillofacial Surgery, Unichristus University Center (UNICHRISTUS), Fortaleza, Brazil; Professor, Division of Oral and Maxillofacial Surgery, Leão Sampaio University Center (UNILEÃO), Juazeiro do Norte, Ceará, Brazil; Professor, Department of Dental Clinic, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil.
The Posnick technique required less torque for mandibular sagittal splitting, but the Wolford technique offered better fracture predictability and inferior alveolar nerve visualization in porcine models.
Area of Science:
- Oral and Maxillofacial Surgery
- Anatomical Research
- Surgical Techniques
Background:
- The optimal technique for mandibular ramus sagittal osteotomy remains undetermined.
- Comparing established methods is crucial for surgical decision-making.
Purpose of the Study:
- To compare fracture patterns, inferior alveolar nerve (IAN) visualization, and torque requirements for mandibular sagittal splitting.
- Evaluate the Hunsuck/Epker, Wolford, and Posnick techniques in a porcine model.
Main Methods:
- Ex vivo randomized, single-blind study using porcine hemimandibles.
- Three groups: Hunsuck/Epker (GHE), Wolford (GW), and Posnick (GP).
- Outcome variables: lingual fracture pattern, torque (N), and IAN visualization.
Main Results:
- Posnick technique required significantly less torque (2.07 N) compared to Hunsuck/Epker (4.45 N) and Wolford (3.00 N).
- GW (93.3%) and GHE (56.7%) showed posterior mandibular canal lingual fractures; GP (90%) showed mylohyoid sulcus fractures.
- IAN visualization exceeded 50% in GW (90%) and GHE (>90%), but was <50% in GP (90%).
Conclusions:
- The Posnick technique demands less torque but yields less favorable fracture patterns and nerve visualization.
- The Wolford technique demonstrates superior predictability for desired fracture patterns and optimal nerve visualization.
- Results from animal models require careful consideration for human application.
