3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible.
The purpose of this prospective observational study was to evaluate whether cone beam CT (CBCT) is a useful tool for analyzing the fracture line in a bilateral sagittal split osteotomy (BSSO). The patient group consisted of 40 consecutive patients (9 males and 31 females) with a mandibular hypoplasia who underwent a BSSO advancement (Hunsuck modification; n=80 splits) between September 2006 and July 2008. The mean age at the time of surgery was 34 years (range 17-61 years). A newly developed lingual split scale was used to categorize the path of the fracture line on the lingual side of the ramus based on one-day postoperative data sets reconstructed from CBCT data. Although all splits (n=80) were performed according to the standardized protocol, only 51% of the fracture lines run according to the Hunsuck's description, whereas 33% ran through the mandibular canal and 16% split otherwise. The split pattern was influenced by the length of the medial osteotomy (p=0.01). In conclusion, 3D imaging is a useful tool for analyzing the surgical outcome of a BSSO and has the potential to provide substantial data on the position of the proximal segments as a result of the lingual fracture line.
Plooij
J M
JM
3D Facial Imaging Research Group Nijmegen-Bruges, Nijmegen, The Netherlands.
Naphausen
M T P
MT
Maal
T J J
TJ
Xi
T
T
Rangel
F A
FA
Swennnen
G
G
de Koning
M
M
Borstlap
W A
WA
Bergé
S J
SJ
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007574:Jaw Relation Record / Q000295:instrumentation; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D014081:Tooth Extraction; D055815:Young Adult