Simultaneous Removal of Third Molars During a Sagittal Split Does Not Increase the Incidence of Bad Splits in Patients Aged 30 Years or Older

Does the Presence of Impacted Mandibular Third Molars Increase the Risk of Bad Split Incidence During Bilateral Sagittal Split Osteotomy?

“…19 We observed that the presence of impacted mandibular third molars during BSSO surgery increased 3.7 times the chance of bad splits incidence. This result was in line with Camargo et al, 8 Verveij et al, 12 and Reyneke et al 20 findings.…”

“…Despite these efforts, this technique remains challenging in some cases. [7][8][9] Several studies have documented BSSO-related complications, including arterial bleeding, unfavorable fractures pattern termed 'bad split'; proximal segment malposition, necrosis of surgical site, as well as, condylar and temporomandibular joint disorders. 1,2,9,10 Bad split is an irregular fracture of the mandible in an inappropriate location during osteotomy.…”

“…1,14,15 The review of the literature revealed that few studies have examined the association between the bad split occurrence and the presence of the impacted third mandibular molar. 1,2,8,9,16 Some studies have indicated that impacted molars can decrease bone quantity in the surgical site, especially at the mandibular angle, and may increase the risk of bad split. 1,9,17 Therefore, it is recommended that the third molars to be extracted at least six months before BSSO surgery.…”

Dal Pont vs Hunsuck: Which Technique Can Lead to a Lower Incidence of Bad Split during Bilateral Sagittal Split Osteotomy? A Triple-blind Randomized Clinical Trial

“…These fractures can cause unstable surgical fixation, malunion, and infection in the osteotomy site [1][2][3][4][5][12][13][14] . The incidence of unfavorable bad split fractures varies from 1% to 23 % in previously conducted studies 1,4,6,7,12,[15][16][17] . The patient's age, gender, mandibular anatomy, presence of mandibular third molar at surgery as well as the surgeon's expertise are all contributing factors to the occurrence of bad split fractures 1,4,6,7,12,[15][16][17][18] .…”

“…The incidence of unfavorable bad split fractures varies from 1% to 23 % in previously conducted studies 1,4,6,7,12,[15][16][17] . The patient's age, gender, mandibular anatomy, presence of mandibular third molar at surgery as well as the surgeon's expertise are all contributing factors to the occurrence of bad split fractures 1,4,6,7,12,[15][16][17][18] . Dal Pont and Hunsuck modifications are both wellestablished procedures in mandibular setback BSSO surgery, and somewhat similar 3,6,7,12 .…”