Which factors affect the lingual fracture pattern in sagittal split ramus osteotomy?

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery

Background:

• Sagittal split ramus osteotomy (SSRO) is a common procedure in orthognathic surgery.
• Understanding factors influencing lingual fracture patterns is crucial for surgical success and minimizing complications.

Purpose of the Study:

• To investigate the relationship between mandibular anatomical variations and osteotomy techniques on lingual fracture patterns in SSRO.
• To categorize lingual split patterns using a standardized scale.

Main Methods:

• Analysis of 312 lingual split patterns from 156 patients undergoing SSRO.
• Evaluation of predictor variables including osteotomy length, type, and bone dimensions.
• Statistical analysis using ANOVA and Pearson chi-squared test.

Main Results:

• The most frequent lingual split pattern was LSS 1 (true Hunsuck).
• A significant association was found between the type of inferior border osteotomy and the lingual split pattern (p=0.001).
• Unfavorable fracture patterns (LSS 4) were most common when the inferior border osteotomy was positioned on the buccal surface.

Conclusions:

• The technique for inferior border osteotomy significantly influences lingual split patterns in SSRO.
• Surgeons should be cautious of unfavorable lingual fractures when the osteotomy is placed buccally.