Influence of inferior border cut on lingual fracture pattern during bilateral sagittal split osteotomy with splitter and separators: A prospective observational study.
Bilateral sagittal split osteotomy (BSSO) is a widely used orthognathic surgery technique. This prospective observational study investigated the correspondence between the planned inferior border cut and the actually executed inferior border cut during BSSO. The influence of the inferior border cut on lingual fracture patterns was also analyzed. Postoperative cone beam computed tomography (CBCT) scans of 41 patients, representing 82 sagittal split osteotomies, were investigated. The inferior border cut was intended to penetrate completely through the caudal cortex. Descriptive statistics were used to analyze the executed inferior border cuts. Mixed models were used to investigate the influence of independent variables such as the surgeon's experience on the inferior border cut. Secondarily the influence of the inferior border cut on lingual fracture patterns and the incidence of bad splits was assessed. The inferior border cut reached the caudal cortex in all cases, but reached the lingual cortex in only 38% of the splits. There was no significant relationship between the inferior border cut and a specific lingual fracture line. In this study, postoperative CBCT analysis revealed that the bone cuts during BSSO were often not placed exactly as planned. No significant relationship between the inferior border cut and lingual fracture patterns or bad splits was, however, detected.
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Pascal N W J
PNWJ
Houppermans
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Jop P
JP
Verweij
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands; Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands.
Gertjan
G
Mensink
Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands.
Peter J J
PJJ
Gooris
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: J.P.R.van_Merkesteyn@lumc.nl.
J P Richard
JPR
van Merkesteyn
D000293:Adolescent; D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D059229:Osteotomy, Sagittal Split Ramus / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult
Fracture pattern; Inferior border cut; Lingual fracture; Orthognathic surgery; Sagittal split osteotomy