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Influence of different techniques for bilateral sagittal split osteotomy on the fracture pattern of the mandibular ramus in the context of orthognathic surgery: a cadaver study

Subject Area Dentistry, Oral Surgery
Term from 2017 to 2020
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 348085678
 
The appearances of malocclusions are manifold and depend on various influencing factors and often occur with functional impairments of occlusion and articulation. By surgical intervention, the position of the jaw joint can be affected and improved. The bilateral sagittal split osteotomy (BSSO) is the surgical procedure of choice to treat these complex cases. Therefore, the lower jaw is detached from the base and repositioned.The most common complications are bad splits (defined as unwanted fractures of the proximal or the distal segment of the mandible) and neurosensory disturbances, resulting from injury to the inferior alveolar nerve (IAN) during surgery, which can affect the daily life of patients. Modifications to this technique as well as the surgical devices have been proposed to address these issues. While osteotomy can be done by bur, saw or ultrasonic device, most techniques for separation of the distal and proximal segments of the mandible based on the use of a chisel.In this planed cadaveric investigation, a split procedure is done according to the standard protocol with a lateral corticotomy anterior to the mandibular angle as well as a modified technique implementing a further osteotomy line at the inferior border of the mandibular body. The osteotomy is performed selectively with conventional drills or ultrasonic surgery followed by a split using a chisel connected to a torque gauge. This results in four study groups: 1.) Standard procedure/drill, 2.) Standard procedure/ultrasonic 3.) Modified procedure/drill, 4.) Modified procedure/ultrasonicThe objective of the investigation is the influence of different techniques and devices for bilateral sagittal split osteotomy on lingual fracture patterns, incidence of bad splits, status of the inferior alveolar nerve, and the necessary force for the split. An ideal operation procedure should be found to reduce the current high risk.
DFG Programme Research Grants
 
 

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