title: Bilateral sagittal split osteotomy in a mandible previously reconstructed with a non-vascularized bone graft.
abstract: We report a bilateral sagittal split osteotomy (BSSO) in a reconstructed mandible. A 28-year-old woman underwent a segmental mandibulectomy due to a multicystic ameloblastoma in the left jaw. After primary plate reconstruction, final reconstruction was performed with a left posterior iliac crest cortico-cancellous autograft. Due to a pre-existing Class II malocclusion, the patient was analyzed for combined orthodontic-surgical treatment. Subsequently, after 1 year of orthodontic treatment, the BSSO was planned. The sagittal split was performed in the remaining right mandible and on the left side in the iliac crest cortico-cancellous autograft. Ten months later, oral rehabilitation was completed with implant placement in the neomandible. Follow-up showed a Class I occlusion, with good function. The patient was very satisfied with the functional and aesthetic results. This case shows that a BSSO can be performed in a reconstructed mandible, without side effects and with good functional and aesthetic results.
authors: Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands. GMensink1@amphia.nl
authors: G
authors: G
authors: Mensink
authors: J P
authors: JP
authors: Verweij
authors: P J J
authors: PJ
authors: Gooris
authors: J P R
authors: JP
authors: van Merkesteyn
mesh_terms: D000328:Adult; D000564:Ameloblastoma / Q000601:surgery*; D064592:Autografts / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D019651:Plastic Surgery Procedures