Evaluation of the Mandibular Ramus Fracture Line After Sagittal Split Ramus Osteotomy Using 3-Dimensional Computed Tomography

Medial cortex fracture patterns after sagittal split osteotomy using short versus long medial cuts: can we obviate bad splits?

“…These observations also proved that the split patterns of the mandibular ramus could be controlled by the position of the end of the lateral bone cut. 2 Plooij et al analysed the fracture lines in SSOs using CBCT. Results showed all splits (n = 80) were performed according to the standardized protocol and only 51% of the fracture lines ran according to Hunsuck's description, whereas 33% ran through the mandibular canal and 16% split otherwise.…”

“…1 Surgeons make an osteotomy at various sites and of various lengths on the medial and lateral aspects of the mandible. 2 Since its introduction, many modifications of the original technique have been described in an attempt to decrease the risk of bad splits, to avoid non-union, and to prevent trauma to the inferior alveolar nerve. 3 Originally, two osteotomy models were suggested for the lingual side of the ramus in SSO, namely a long osteotomy line that extends beyond the lingula and finishes at the posterior border or near it, and a short osteotomy line that ends approximately at the lingula.…”

“…However, this method does not allow precise observation of the split lines. 2 Patterns of lingual fracture after SSO have been studied using conventional three-dimensional (3D) computed tomography (CT) scans. 2,7 Cone beam CT (CBCT) produces two-dimensional (2D) images that may be reconstructed into 3D.…”

“…2 Patterns of lingual fracture after SSO have been studied using conventional three-dimensional (3D) computed tomography (CT) scans. 2,7 Cone beam CT (CBCT) produces two-dimensional (2D) images that may be reconstructed into 3D. 8 CBCT has a lower radiation dose compared with a conventional CT scan.…”

Three-dimensional fracture pattern analysis of the Obwegeser and Dal Pont bilateral sagittal split osteotomy

“…8 Other researchers have since used the 3D CBCT technology to analyze lingual fracture patterns. 9,10 All of these previous publications investigated the Hunsuck and Epker modification. The more traditional Obwegeser and Dal Pont technique has not yet been evaluated by means of 3D imaging.…”