Presence of mandibular third molars during bilateral sagittal split osteotomy increases the possibility of bad split but not the risk of other post-operative complications.
Timing of third molar removal in relation to bilateral sagittal split osteotomy (BSSO) is controversial, especially with regard to post-operative complications. We investigated the influence of mandibular third molar presence on complications after BSSO with sagittal splitters and separators, by a retrospective record review of 251 patients (502 surgical sites). Mandibular third molars were present during surgery at 169 sites and removed at least 6 months preoperatively in 333 sites. Bad splits occurred at 3.0 % (5/169) and 1.5% (5/333) of the respective sites. Presence of mandibular third molars significantly increased the risk of bad splits (OR 1.08, CI 1.02-1.13, p < 0.01). The mean incidences of permanent neurosensory disturbances, post-operative infection, and symptomatic removal of the osteosynthesis material were 5.4% (OR, 0.89; 95% CI, 0.79-1.00; p = 0.06), 8.2% (OR, 1.09; 95% CI, 0.99-1.20; p = 0.63), and 3.4% (OR, 0.97; 95% CI, .92-1.03; p = 0.35) per site, respectively, without a significant influence of mandibular third molar status. In conclusion, the presence of mandibular third molars during surgery increases the possibility of bad split but does not affect the risk of other complications. Therefore, third molars can be removed concomitantly with BSSO using sagittal splitters and separators.
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Jop P
JP
Verweij
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands; Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands.
Gertjan
G
Mensink
Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands.
Marta
M
Fiocco
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: J.P.R.van_Merkesteyn@lumc.nl.
J P Richard
JP
van Merkesteyn
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D003389:Cranial Nerve Diseases / Q000209:etiology; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008337:Mandibular Fractures / Q000209:etiology*; D008340:Mandibular Nerve / Q000473:pathology; D008875:Middle Aged; D008964:Molar, Third / Q000473:pathology* / Q000601:surgery; D061646:Operative Time; D009984:Orthopedic Fixation Devices / Q000009:adverse effects; D059229:Osteotomy, Sagittal Split Ramus / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D020886:Somatosensory Disorders / Q000209:etiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014081:Tooth Extraction / Q000379:methods; D055815:Young Adult
Mandibular osteotomy; Osteotomy; Post-operative complications; Risk; Sagittal split ramus; Third molar