Postoperative fractures of the lingual plate after bilateral sagittal split osteotomies

Variations in the anatomical dimensions of the mandibular ramus and the presence of third molars: its effect on the sagittal split ramus osteotomy

“…Complications associated with the surgical technique when performing the sagittal split osteotomy are well documented in the literature, some of the most common being unfavourable fractures of either the distal or proximal segment, damage to the inferior alveolar nerve, failure of fixation and condylar sag. [6][7][8][9][10][11][12] Although the anatomy of the posterior part of the mandible lends itself to the surgical design, it has become evident that the specific anatomy of each individual mandibular ramus differs which may play a significant role in the ease of splitting the ramus. Various technical factors could influence the successful completion of the split and there are several important anatomical structures that should be considered when the split is performed.…”

“…Various technical factors could influence the successful completion of the split and there are several important anatomical structures that should be considered when the split is performed. 12 Maintaining the mandibular condyle/fossa relationship forms the basis for the achievement of the new planned occlusion. Correct positioning of the condyles in the fossae during surgery is therefore mandatory and is certainly challenging.…”

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

“…Results demonstrated that significant risk factors for splits included a vertical mandibular height of 2 cm or less distal to the last molar tooth, a depth of 0.6 cm or less from the apex of the last molar root, or an impacted third molar to the lower border. 13 Falter et al declared that even if precautions are taken, a bad split may occur during SSO of the mandible. They found this complication to have a low incidence (0.7% of all SSOs) and healing to be uneventful.…”

“…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.…”

A Bony Landmark ‘RAI Triangle’ to Prevent ‘Misplaced and Misdirected’ Medial Cut in SSRO

“…Sagittal split ramus osteotomy of the mandible is a versatile and reliable operation-used to advance or set back the mandible [1]. This could be the procedure which defined the evolution of the specialty of oral surgery, the art, to the specialty of oral and maxillofacial surgery, the science.…”