title: Modified Mandibular Inferior Border Sagittal Split Osteotomy Reduces Postoperative Risk for Developing Inferior Border Defects.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the impact of a modified sagittal split osteotomy (SSO) surgical technique on the incidence of persisting inferior border defects. The secondary aim was to identify risk factors associated with the development of these complications.
  
  
  METHODS
  The patient charts and radiographs of 276 consecutive patients who underwent bilateral SSO, performed by a single surgeon in 2 different centers from July 2012 to September 2014, were retrospectively examined. The predictor variable was length of advancement. The outcome variable was the presence or absence of an inferior border defect. Other variables included age and side of the jaw. In all cases the same surgical technique was used. All statistical analyses were performed using SAS software, version 9.4 (SAS Institute, Cary, NC).
  
  
  RESULTS
  The analysis included 408 operation sites in 204 patients (132 female and 72 male patients; median age, 22 years; age range, 13 to 66 years). In 5.1% of operation sites an osseous defect at the lower border of the mandible was observed. Age at the time of surgery (P < .0001) and length of advancement (P = .0111) were identified as risk factors for the development of a persisting osseous defect at the inferior border of the osteotomy gap after SSO.
  
  
  CONCLUSIONS
  This study confirms the findings previously reported by our research group that the modified inferior border osteotomy technique in SSO results in a substantial lower frequency of persisting inferior border defects. Surgeons are advised to ensure that the lingual cortex of the inferior border is not included in the split during mandibular advancements, and in cases in which the advancement is more than 10 mm and/or the patient is older than 30 years, surgeons might want to consider using a bone graft or a bone graft substitute.
authors: Postdoctoral Fellow, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium. Electronic address: joagbaje@gmail.com.
authors: Jimoh Olubanwo
authors: JO
authors: Agbaje
authors: Resident Doctor, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
authors: Bert
authors: B
authors: Gemels
authors: Visiting Researcher, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
authors: Ahmed S
authors: AS
authors: Salem
authors: Statistician, Centre for Educational Effectiveness and Evaluation, Catholic University of Leuven, Leuven, Belgium.
authors: Dickson
authors: D
authors: Anumendem
authors: Head of Oral and Maxillofacial Surgery Department, St John's Hospital, Genk, Belgium.
authors: Luc
authors: L
authors: Vrielinck
authors: Professor and Head of Department Oral and Maxillofacial Surgery, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and Faculty of Medicine, Hasselt University, Diepenbeek, Belgium.
authors: Constantinus
authors: C
authors: Politis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D063168:Mandibular Osteotomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult