Modification of the bilateral sagittal split osteotomy (BSSO) in a study using pig mandibles

Schoen, Patrick; Frotscher, M.; Eggeler, Gunther; Keßler, Peter; Wolff, Klaus‐Dietrich; Boeckmann, R.

doi:10.1016/j.ijom.2010.09.028

Cited by 15 publications

(9 citation statements)

References 19 publications

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“…These fracture patterns also increase the bone contact surface area, which proves advantageous in cases involving mandibular advancement. Our findings align with previous studies conducted on cadaveric animals [ 20 , 21 ] and a cadaveric human study [ 22 ]. However, our results diverge from the clinical studies of Houppermans et al [ 23 ] and Mohlhenrich et al [ 24 ], who reported no significant association between the inferior border cut and the lingual split pattern.…”

Section: Discussionsupporting

confidence: 93%

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Al-Dawoody,

Hamad,

Kheder Khrwatany

et al. 2023

Head Face Med

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Aim The purpose of this study was to evaluate the effect of adding a fourth osteotomy at the lower border of the mandible on the lingual cortical fracture pattern in bilateral sagittal split ramus osteotomies. Patients and methods The sample of the study consisted of 20 patients (12 male and 8 female, with a mean age of 26.79 ± 7.12 years) with mandibular deformities who needed bilateral sagittal split ramus osteotomy. One side underwent a traditional sagittal split ramus osteotomy, and the procedure was modified on the other side by adding a 1 cm horizontal osteotomy at the lower border of the mandible, just distal to the caudal end of the vertical buccal osteotomy cut. A 3D CBCT was used to identify the split pattern. Results In the total sample, 40% of the lingual splits ran vertically toward the lower border of the mandible (LSS1), 20% of the splits passed horizontally to the posterior border of the mandible (LSS2), 32.5% of the splits took place along the inferior alveolar canal (LSS3), and 7.5% of the splits were unfavourable fractures (LSS4). On the inferior border osteotomy sides, the distribution of LSS1, LSS2, LSS3, and LSS4 was 10 (25%), 6 (15%), 4 (10%), and 0 (00), respectively. Their distribution on the sides without inferior border osteotomy was 6 (15%), 8 (20%), 13 (32.5%), and 3 (7.5%), respectively. Statistical analysis revealed a significant difference between the two groups (p < 0.05). Conclusion Inferior border osteotomy tends to direct the lingual split fracture line toward the lower and posterior borders of the mandible and minimizes bad splits; however, further studies are needed to confirm our findings.

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Section: Discussionsupporting

confidence: 93%

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Al-Dawoody,

Hamad,

Kheder Khrwatany

et al. 2023

Head Face Med

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show abstract

“…Using pig mandibles ex vivo, Schoen et al 13 Among others causes, the presence of less cancellous bone and more cortical bone in the area of the mandibular angle in the pig mandible was discussed as a possible reason. In a follow-up study with the same setup using human mandibles, only one of 35 mandibles fractured exactly in the way described by Obwegeser and Dal Pont.…”

Section: Discussionmentioning

confidence: 99%

“…These findings support the present results showing that significantly more fractures over the buccal plate occur if a buccal bone cut end of the medial osteotomy and a buccal bone cut end of the lateral osteotomy are performed. MacIntosh, in a 13-year review, stated that the split did not correspond precisely to the lines of Obwegeser and Dal Pont sectioning in less than 13 When Jönsson et al 19 observed a very low incidence of only 13% of ideal sectioning in their patients, MacIntosh considered a lateral bone cut through the inferior border to be the reason, assuming imperfect sagittal splitting if the bur is inclined too severely. 18 According to the present study findings, performing the vertical bone cut to the centre of the inferior border or lingual through the inferior border appears to be of no determinant importance to the fracture pattern achieved.…”

Section: Discussionmentioning

confidence: 99%

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

Dreiseidler

Bergmann

Zirk

et al. 2016

International Journal of Oral and Maxillofacial Surgery

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“…Schoen et al 21 later reported a similar bone cut to decrease the magnitude of resistance encountered during splitting. The goal of using this additional bone saw in the inferior cortex was to increase the predictability and control of the split.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Angled Osteotomy Design Aimed to Influence the Lingual Fracture Line in Bilateral Sagittal Split Osteotomy: A Human Cadaveric Study

Verweij

Mensink

Houppermans

et al. 2015

Journal of Oral and Maxillofacial Surgery

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Modification of the bilateral sagittal split osteotomy (BSSO) in a study using pig mandibles

Cited by 15 publications

References 19 publications

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

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

Angled Osteotomy Design Aimed to Influence the Lingual Fracture Line in Bilateral Sagittal Split Osteotomy: A Human Cadaveric Study

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