Bilateral Sagittal Split Osteotomy

Abstract

The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities. The technique has been in practice since the late 1800s, but did not reach widespread acceptance and use until several modifications were described in the 1960s and 1970s. Those modifications came from a desire to make the procedure safer, more reliable, and more predictable with less relapse. Those goals continue to stimulate innovation in the field today and have helped the procedure evolve to be a very dependable, consistent method of correction of many types of malocclusion. The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of the bilateral sagittal split osteotomy to fully understand the procedure and to counsel the patient.

Keywords

bilateral sagittal split osteotomy - mandible - orthognathic

• References

• 1 Ow A, Cheung LK. Skeletal stability and complications of bilateral sagittal split osteotomies and mandibular distraction osteogenesis: an evidence-based review. J Oral Maxillofac Surg 2009; 67 (11) 2344-2353
• 2 McCarthy JG, Katzen JT, Hopper R, Grayson BH. The first decade of mandibular distraction: lessons we have learned. Plast Reconstr Surg 2002; 110 (7) 1704-1713
• 3 Aziz SR. Simon P. Hullihen and the origin of orthognathic surgery. J Oral Maxillofac Surg 2004; 62 (10) 1303-1307
• 4 Steinhäuser EW. Historical development of orthognathic surgery. J Craniomaxillofac Surg 1996; 24 (4) 195-204
• 5 Obwegeser HL. Orthognathic surgery and a tale of how three procedures came to be: a letter to the next generations of surgeons. Clin Plast Surg 2007; 34 (3) 331-355
• 6 Caldwell JB, Letterman GS. Vertical osteotomy in the mandibular raml for correction of prognathism. J Oral Surg (Chic) 1954; 12 (3) 185-202
• 7 Trauner R, Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 1957; 10 (7) 677-689
• 8 Dal Pont G. Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 1961; 19: 42-47
• 9 Hunsuck EE. A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 1968; 26 (4) 250-253
• 10 Epker BN. Modifications in the sagittal osteotomy of the mandible. J Oral Surg 1977; 35 (2) 157-159
• 11 Schmoker R, Spiessl B, Tschopp HM, Prein J, Jaques WA. [Functionally stable osteosynthesis of the mandible by means of an excentric-dynamic compression plate. Results of a follow-up of 25 cases]. SSO Schweiz Monatsschr Zahnheilkd 1976; 86 (2) 167-185
• 12 Takahashi H, Moriyama S, Furuta H, Matsunaga H, Sakamoto Y, Kikuta T. Three lateral osteotomy designs for bilateral sagittal split osteotomy: biomechanical evaluation with three-dimensional finite element analysis. Head Face Med 2010; 6: 4
• 13 D'Agostino A, Trevisiol L, Gugole F, Bondí V, Nocini PF. Complications of orthognathic surgery: the inferior alveolar nerve. J Craniofac Surg 2010; 21 (4) 1189-1195
• 14 Van Sickels JE, Hatch JP, Dolce C, Bays RA, Rugh JD. Effects of age, amount of advancement, and genioplasty on neurosensory disturbance after a bilateral sagittal split osteotomy. J Oral Maxillofac Surg 2002; 60 (9) 1012-1017
• 15 Pepersack WJ, Chausse JM. Long term follow-up of the sagittal splitting technique for correction of mandibular prognathism. J Maxillofac Surg 1978; 6 (2) 117-140
• 16 Thilander B, Rubio G, Pena L, de Mayorga C. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod 2002; 72 (2) 146-154