title: Occurrence of a 'bad' split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients.
abstract: The purpose of this study was to assess the prevalence of a 'bad' split after sagittal ramus osteotomies (SRO) and report the results of initial mandibular healing. A retrospective cohort study derived from patients treated by a single surgeon at one institution between 2004 and 2013 was performed. An index group consisting of a series of subjects with a spectrum of bimaxillary dentofacial deformities also involving the chin and symptomatic chronic obstructive nasal breathing was identified. The SRO design, bicortical screw fixation technique, and perioperative management were consistent. Outcome variables included the occurrence of a 'bad' split and the success of initial SRO healing. Two hundred sixty-two subjects undergoing 524 SROs met the inclusion criteria. Their average age was 25 years (range 13-63 years) and 134 were female (51%). Simultaneous removal of a third molar was performed during 209 of the SROs (40%). There were no 'bad' splits. All subjects achieved successful bone union, the planned occlusion, and return to a chewing diet and physical activities by 5 weeks after surgery. The presence of a third molar removed during SRO was not associated with an increased frequency of a 'bad' split or delayed mandibular healing.
authors.affiliation: Posnick Center for Facial Plastic Surgery, Chevy Chase, MD, USA; Georgetown University, Washington, DC, USA; University of Maryland School of Dentistry, Baltimore, MD, USA; Howard University College of Dentistry, Washington, DC, USA. Electronic address: jposnick@drposnick.com.
authors.forename: J C
authors.initials: JC
authors.lastname: Posnick
authors.affiliation: Oral and Maxillofacial Surgery, Howard University Hospital, Washington, DC, USA.
authors.forename: E
authors.initials: E
authors.lastname: Choi
authors.affiliation: Oral and Maxillofacial Surgery, Howard University Hospital, Washington, DC, USA.
authors.forename: S
authors.initials: S
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D063169:Dentofacial Deformities / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery; D059229:Osteotomy, Sagittal Split Ramus / Q000009:adverse effects / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014081:Tooth Extraction; D014945:Wound Healing; D055815:Young Adult
keywords: Posnick; bad split; bilateral sagittal split osteotomy; low and short; orthognathic; sagittal ramus osteotomy