title: Risk factors for common complications associated with bilateral sagittal split osteotomy: A literature review and meta-analysis.
abstract: The most common complications that are associated with bilateral sagittal split osteotomy are: bad splits, postoperative infection, removal of osteosynthesis material, and neurosensory disturbances of the lower lip. Particularly in elective orthognathic surgery, it is important that surgeons inform their patients about the risk of these complications and attempt to minimize these risks. The purpose of this literature review and meta-analysis is to provide an overview of these common complications and their risk factors. After a systematic electronic database search, 59 studies were identified and included in this review. For each complication, a pooled mean incidence was computed. Both the pooled study group and the pooled 'complication group' were analysed. The mean incidences for bad split (2.3% per SSO), postoperative infection (9.6% per patient), removal of the osteosynthesis material (11.2% per patient), and neurosensory disturbances of the lower lip (33.9% per patient) are reported. Regularly reported risk factors for complications were the patient's age, smoking habits, presence of third molars, the surgical technique and type of osteosynthesis material. This information may help the surgeon to minimize the risk of these complications and inform the patient about the risks of complications associated with bilateral sagittal split osteotomy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jop P
authors.initials: JP
authors.lastname: Verweij
authors.affiliation: Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Pascal N W J
authors.initials: PN
authors.lastname: Houppermans
authors.affiliation: Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Gooris
authors.affiliation: Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Gertjan
authors.initials: G
authors.lastname: Mensink
authors.affiliation: Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: J.P.R.van_Merkesteyn@lumc.nl.
authors.forename: J P Richard
authors.initials: JP
authors.lastname: van Merkesteyn
mesh_terms: D006801:Humans; D059229:Osteotomy, Sagittal Split Ramus; D011183:Postoperative Complications; D012307:Risk Factors
keywords: Bad split; Infection; Inferior alveolar nerve; Neurosensory; Orthognathic surgery; Osteosynthesis material