title: Preoperative removal of lower third molars and bilateral sagittal split osteotomy in the UK.
abstract: To find out what consultants in Oral and Maxillofacial Surgery (OMFS) in the UK think about complications of bilateral sagittal split osteotomy (BSSO) in relation to lower third molars we organised a national postal questionnaire during 2012-13. Of 378 consultants, 192 practised orthognathic surgery of whom 132 replied (a 69% response rate). Eighty-one respondents routinely removed lower third molars before BSSO; 51 did not. Eighty-nine respondents thought that there was an increased risk of complications if third molars were present at the time of BSSO, mainly an increased risk of unfavourable fractures. Forty-three respondents did not think there was an increased risk of complications of BSSO when third molars were present. Of the 81 who routinely removed the lower third molars, 13 removed them within the six-month period before BSSO, 56 removed them 6-12 months before, and 11 removed them more than 12 months before. There seemed to be no difference in self-reported unfavourable fracture rates between those surgeons who routinely removed lower third molars and those who did not. The results of the questionnaire showed that there was considerable variation in surgical practice across the UK in the management of lower third molars before BSSO, both in terms of whether or not to remove these teeth at all, and if so, when to remove them.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. Electronic address: srice3@nhs.net.
authors.forename: Steven
authors.initials: S
authors.lastname: Rice
authors.affiliation: Department of Orthodontics, Dundee Dental Hospital and School, Park Place, Dundee DD1 4HN, United Kingdom. Electronic address: Paul_Serrant@hotmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Serrant
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. Electronic address: slaverick@nhs.net.
authors.forename: Sean
authors.initials: S
authors.lastname: Laverick
authors.affiliation: Department of Orthodontics, Dundee Dental Hospital and School, Park Place, Dundee DD1 4HN, United Kingdom. Electronic address: grant.mcintyre@nhs.net.
authors.forename: Grant
authors.initials: G
authors.lastname: McIntyre
mesh_terms: D006801:Humans; D008334:Mandible; D008964:Molar, Third; D010027:Osteotomy; D059229:Osteotomy, Sagittal Split Ramus; D014081:Tooth Extraction; D006113:United Kingdom
keywords: BSSO; Bilateral sagittal split osteotomy; Lower third molars; Mandibular osteotomy; Orthognathic surgery