Unveiling the link between impacted third molars and bad split risk in sagittal split ramus osteotomy: A 12-year...

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Dental Anatomy

Background:

• Bad splits are a recognized complication of Bilateral Sagittal Split Osteotomy (BSSO).
• The predictability of bad split occurrence in BSSO remains a challenge.
• The influence of mandibular third molars on BSSO complications requires further investigation.

Purpose of the Study:

• To investigate the association between mandibular third molars and the incidence of bad splits following BSSO.
• To determine if the presence, impaction status, or anatomical position of third molars impacts bad split patterns.
• To identify risk factors contributing to bad splits during BSSO.

Main Methods:

• Retrospective analysis of 819 patients undergoing BSSO between 2012 and 2023.
• Evaluation of 1638 osteotomy sites, categorized by third molar status (retained vs. removed).
• Statistical analysis to assess the correlation between third molar characteristics and bad split occurrence.

Main Results:

• Bad splits occurred in 2.38% of all osteotomy sites.
• No significant difference in bad split incidence was found between patients with retained versus previously removed third molars (p=0.77).
• Impaction status (p=0.74) and anatomical position (p=0.33) of third molars did not correlate with bad splits. Older patients with retained third molars showed a higher incidence of bad splits (p=0.004).

Conclusions:

• The presence or characteristics of mandibular third molars alone do not significantly increase the risk of bad splits in BSSO.
• Patient age may be a contributing factor to bad split occurrence in individuals with retained third molars.
• Further research is warranted to elucidate the multifactorial nature of bad splits in BSSO.