Sub-lingula Osteotomy-A Novel Modification of Sagittal Split Osteotomy.

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Surgical Anatomy

Background:

• Sagittal split osteotomy is a complex procedure with potential complications.
• Existing modifications aim to improve safety and predictability.
• Epker's 1957 modification is widely accepted but presents challenges in medial ramus osteotomy.

Purpose of the Study:

• To introduce and evaluate a novel sublingula technique for medial ramus osteotomy in sagittal split osteotomy.
• To assess the ease, predictability, and safety of the sublingula technique compared to traditional methods.
• To determine if the technique reduces the risk of bad splits and inferior alveolar nerve damage.

Main Methods:

• A novel sublingula technique for medial ramus osteotomy was developed.
• Fifteen patients (30 sides) underwent sagittal split osteotomy using the sublingula technique.
• Cone-beam computed tomography (CBCT) was utilized for pre-operative anatomical localization.

Main Results:

• The sublingula technique facilitates easier and more predictable medial ramus osteotomy.
• The modified osteotomy is characterized by a low and short cut, minimizing the risk of bad splits.
• No additional risk of damage to the inferior alveolar nerve was observed.

Conclusions:

• The sublingula technique offers a reliable modification for sagittal split osteotomy, particularly for the medial ramus osteotomy.
• CBCT imaging aids in precise planning, making the technique suitable for surgeons with varying experience levels.
• This approach enhances surgical outcomes by improving ease of execution and reducing intraoperative risks.