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Mandibular ramus split patterns following sagittal split ramus osteotomy - evaluation with multifactorial risk
Phasathorn Jewrasumnuay1, Shinnosuke Nogami2, Ryuhei Goke1
1Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Oral and Maxillofacial Surgery
|August 13, 2026
Summary
Sagittal split ramus osteotomy (SSRO) split patterns are influenced by patient anatomy and demographics. Surgeons can adjust buccal horizontal osteotomy (BHO) type to prevent complications during SSRO procedures.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Anatomical Risk Factors
Background:
- Sagittal split ramus osteotomy (SSRO) is a common procedure for correcting mandibular deformities.
- Split patterns, both buccal and lingual, can lead to complications.
- Identifying risk factors is crucial for improving surgical outcomes.
Purpose of the Study:
- To identify novel risk factors influencing buccal and lingual split patterns in SSRO.
- To analyze the association between mandibular ramus anatomy and split patterns.
- To provide insights for preventing SSRO complications.
Main Methods:
- Retrospective cohort study of 658 SSRO cases using the Hunsuck technique.
- Analysis of demographic and mandibular anatomical factors as predictors.
- Classification of split patterns as outcome variables.
Main Results:
- Posterior ramus length and buccal horizontal osteotomy (BHO)-buccal type significantly correlated with buccal bad splits.
- Younger age, male gender, wider transverse ramus width, and BHO-buccal type were associated with long lingual splits.
- Shorter posterior ramus length and BHO-lingual type linked to short lingual splits.
Conclusions:
- Buccal and lingual split patterns are influenced by patient demographics and mandibular anatomy.
- While some factors are uncontrollable (e.g., age, gender), BHO type is modifiable.
- Identified risk factors aid surgeons in patient evaluation and treatment planning to prevent SSRO complications.
