title: In vitro comparison of the sagittal split osteotomy with and without inferior border osteotomy.
abstract: OBJECTIVE
  By adding an osteotomy of the inferior border of the mandibular body to the classic sagittal split osteotomy, the authors expected to prevent unfavorable splits and damage to the inferior alveolar nerve.
  
  
  METHODS
  Thirty-five human mandibles were used to perform 70 sagittal split osteotomies as an in vitro study. Conducted as a split-mouth model, each mandible was split at the midline. One side of the mandible was split using the traditional Obwegeser-Dal Pont technique, and the other side was split in the same manner with an additional osteotomy of the inferior mandible border. The torque used to split the mandible was measured, and the fracture line of the mandible was recorded.
  
  
  RESULTS
  The average torque associated with the original technique was 1.38 Nm (standard deviation, 0.60 Nm), with a fracture line along the mandibular canal. The average torque required to split the hemimandible with the modified technique was 1.02 Nm (standard deviation, 0.50 Nm), a significant (P < .001) difference, with a fracture line parallel to the posterior ramus of the mandible. The fracture pattern depended significantly on the technique used (P < .001), but not on the applied torque force.
  
  
  CONCLUSIONS
  By adding an osteotomy of the inferior mandibular border to the sagittal split osteotomy, less torque was needed to split the mandible. The fracture line was more predictable, even when all the surgical manipulations were performed at a safe distance from the inferior alveolar nerve.
authors.affiliation: Senior Resident, Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: go2roland@gmx.net.
authors.forename: Roland
authors.initials: R
authors.lastname: Böckmann
authors.affiliation: Resident, Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus, Ruhr University, Bochum, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Schön
authors.affiliation: Senior Civil Engineer, Institute for Materials, Ruhr University, Bochum, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Neuking
authors.affiliation: Senior Resident, Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Joeri
authors.initials: J
authors.lastname: Meyns
authors.affiliation: Professor, Head of Department, Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kessler
authors.affiliation: Professor, Head of Department, Institute for Materials, Ruhr University, Bochum, Germany.
authors.forename: Gunther
authors.initials: G
authors.lastname: Eggeler
mesh_terms: D006801:Humans; D066298:In Vitro Techniques; D008340:Mandibular Nerve / Q000473:pathology; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*