Stolker, volgens besluit van het college voor promoties te verdedigen op dinsdag 12 september 2017. Mar 26, 2010 bilateral sagittal split osteotomy bsso is the most common orthognathic surgical procedure. However, a bilateral sagittal split can be more consistently fixed with plates and screws and hence allows the patient earlier function. Different techniques such as intra oral vertical ramus osteotomy ivro, extra oral vertical ramus osteotomy evro or subapical osteotomy and sagittal split. A sagittal split osteotomy is an oral surgery procedure that is done to correct any serious misalignment of the upper and lower teeth. Stability after bilateral sagittal split osteotomy.
This allows the front part of the mandible to slide backward or forward until the teeth are aligned. A bilateral sagittal split osteotomy is performed by oral and maxillofacial surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing. Pdf the technique of sagittal split osteotomy of the mandibular ramus is an established technique that has been evolving over the years, with. Decompression or marsupialization technique for managing large odontogen. Pdf risk factors for common complications associated. Aug 31, 2016 bilateral sagittal spilt osteotomy and genioplasty in patient with lymphatic malformation video type. Surgical correction of asymmetric mandibular prognathism.
Jun 03, 2016 there is a higher incidence of inferior alveolar nerve injury with a bilateral sagittal split osteotomy than with a vertical ramus osteotomy when used to set back the mandible. Extraoral vertical subcondylar osteotomy with rigid fixation. The technique resembles the method described by hinds and girotti 1967, with the exception that the osteotomy has an inverted lshape and two titanium 2. Bilateral sagittal split osteotomy of mandible bsso is a surgical method used to correct the sagittal, transversal and vertical position of the lower jaw. The authors treated 25 patients who underwent bilateral sagittal split osteotomies due to class ii dentoskeletal deformities. It can be concluded that the osteotomy design influences mechanical resistance and that the linear ssro offers the best mechanical resistance. This study was performed to evaluate threedimensional positional change of the condyle using threedimensional computed tomography 3dct following unilateral sagittal split ramus osteotomy ussro in patients with mandibular prognathism. Nowadays, the obwegeser, dal pont, and hunsuck modification is probably the most used bsso design. Sagittal split mandibular osteotomy definition of sagittal. Bilateral saggital split osteotomy jaw surgery medical. Surgical correction of asymmetric mandibular prognathism with. The bilateral sagittal split osteotomy bsso can be considered a milestone in surgery in general. Bilateral sagittal split osteotomy bsso is the most common orthognathic surgical procedure. Bilateral sagittal spilt osteotomy and genioplasty in.
Hybrid fixation in the bilateral sagittal split osteotomy. Bilateral sagittal split osteotomy jefferson university. Bilateral sagittal split osteotomy bsso is a widely used orthognathic surgical. Boston, massachusetts 02111 evaluation of the surgical procedure of sagittal split osteotomy of the mandibular ramus joseph h. Bilateral sagittal split osteotomy bsso, according to obwegeser and dal pont, is a wellestablished method in maxillofacial surgery and probably the most frequently used technique for total osteotomy of the mandible. Removal of deeply impacted mandibular molars by sagittal. This article describes the technique for the sagittal split mandibular ramus osteotomy in a stepbystep fashion with tips and traps with each step. The patients were operated according to a modified obwegeser bilateral sagittal split osteotomy bsso. Assessment of nerve function after mandible surgery with a.
The surgical protocol used at oslo university hospital for evso with rigid fixation is presented below. Since then, several modifications of the technique have been introduced with the aim of improving surgical convenience, minimizing morbidity, and maximizing procedural stability. Oct 07, 2014 the sagittal split osteotomy obwegeserdal pont bellepker procedure 20. No distinction was seen between the short and longterm ratios for mentolabial fold.
Twelve sagittal split osteotomies were fixed with 12 macrosorb plates in six patients, and 24 osteotomies were filled with 32 polymax plates in 12 patients. Original article influence of the design in sagittal split. Condylar positioning changes following unilateral sagittal. Jul 16, 2012 this animation shows the results of a sagittal split osteotomy surgical procedure in which the mandible is moved into a more benefical position for the patient. Surgical technique a team of 6 senior surgeons were involved in the treatment. The fixation of sagittal split osteotomies with miniplates.
Recovery of inferior alveolar nerve injury after bilateral. Extraoral vertical subcondylar osteotomy with rigid. Soft tissue profile changes after bilateral sagittal split. The bilateral sagittal split osteotomy, or bsso for short, has evolved into an effective and preferred surgical procedure for mandibular advancement or setbacks.
The ability to rigidly and properly fix the fractured segments at the time of surgery may facilitate healing in the immediate postoperative period and reduce the displacement possibility of the bony segments, particularly the condylar proximal segment 27. Although the technique still presents a certain degree of technical difficulty, it has become a reliable procedure in orthognatic surgery. This technique was carried out via an intraoral approach and introduced the. Several technical modifications based on the anatomical position of the neurovascular bundle and its bony mandibular canal have been developed, aiming to prevent injury to the intraalveolar nerve we hypothesized that the incidence of neurosensory disturbance nsd should be reduced using our bilateral sagittal split osteotomy bsso technique, because direct intraalveolar nerve injury can be. The sagittal split osteotomy obwegeserdal pont bellepker procedure 20. Bilateral sagittal spilt osteotomy and genioplasty in patient with lymphatic malformation video type. The surgical procedure consists of bilateral osteotomies of the mandible, in which the angulus area is exposed by intraoral incisions and split in a near sagittal plane on both sides. Bilateral sagittal split osteotomy bsso is a well documented standardized and relatively safe operation to correct jaw deformities such as mandibular retrognathism. This animation shows the results of a sagittal split osteotomy surgical procedure in which the mandible is moved into a more benefical position for the patient. Mar, 2007 sagittal split osteotomy sso is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures.
Surgical procedures of mandibular sagittal split osteotomy on during mandibular sagittal split osteotomy, the lower jaw is removed. Mandibular sagittal split ramus osteotomy is the most common mandibular orthognathic procedure. A bilateral sagittal split osteotomy is a type of jaw surgery in which the lower jaw mandible is split bilaterally moved forward or backward to straighten it to a more balanced and functional position. The bilateral sagittal split mandibular ramus osteotomy. Neurosensory disturbance is a common complication of bilateral sagittal split osteotomy bsso. Sagittal split osteotomy sso is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures.
Sagittal split osteotomy definition of sagittal split. Since 1957, when it was introduced by trauner and obwegeser 1, 2, 3, it has undergone a number of modifications in surgical technique as well as fixation of the segments. A new technique for mandibular osteotomy springerlink. Furthermore, the study focuses on th e measurement of neurosensory di sturbance with ea sily available. There is a higher incidence of inferior alveolar nerve injury with a bilateral sagittal split osteotomy than with a vertical ramus osteotomy when used to set back the mandible. Bsso bilateral saggital split osteotomy jaw surgery. Bilateral sagittal split osteotomy bsso of the mandible is one of the most frequently performed surgical procedures. This osteotomy technique originally was described by trauner and obwegeser in 1957. The technique has been in practice since the late 1800s, but did not reach. Bilateral sagittal split ramus osteotomy bssro is commonly used to correct mandibular prognathism or retrognathism. This study investigated a new technique for the bilateral sagittal split osteotomy bsso by adding a new osteotomy line at the inferior border of the mandible in the obwegeserdal pont operation. Bilateral sagittal spilt osteotomy and genioplasty in patient. The modifications of the sagittal ramus split osteotomy. Ten mandibular plate, screw, hardtissue, and softtissue specimens were taken at 3, 6, 9, or 12 months postoperatively in secondary operations e.
May 06, 2014 bilateral sagittal split ramus osteotomy an orthognathic surgery done at richardson dental and craniofacial hospital, nagercoil, tamilnadu, india. It is performed to correct types of malocclusion, a misalignment of teeth. Engel, neurosensory alterations and function of the temporomandibular joint after high oblique sagittal split osteotomy. A new hybrid technique for performing a safer bilateral sagittal. Originally developed in the middle of the last century by hugo obwegeser, at the department of surgery, medical university of graz, austria, the technique quickly found its way into the armamentarium of surgical procedures in orthognathic surgery. Mandibular first and second molars do not share the same frequency of occurrence. The bone on the sagittal or side of the lower mandible of the jaw is cut on each side to form a split. In some cases, a supernumerary fourth molar can be seen as unerupted and, in. Mandibular sagittal split osteotomy orange county surgeons. Mohammad hassan samandari1, navid naghdi1 and milad. This study examined two patients exhibiting skeletal class iii malocclusion with facial asymmetry who underwent ussro for a.
Iii nerve manipulation during bilateral sagittal split osteotomy increases neurosensory disturbance and decreases patient satisfaction. Le fort osteotomy transverse sectioning and repositioning of the maxilla. The bilateral sagittal split osteotomy is an indispensable surgical procedure for the. Compared to conventional bsso technique, less neurosensory complications, risk of condylar sagging and bad splitting are expected in suggested modification. Mandibular third molars are the most common impacted teeth. Lip paresthesia, mandibular prognathism, muscular function, sagittal split osteotomy. Patients with mandibular prognathism or retrognathism may also present with a.
The mandibular osteotomy site defects 815 mm were augmented with bioactive glass s53p4. Lip paresthesia, mandibular prognathism, muscular function, sagittal. Dec 10, 2014 about bilateral sagittal split osteotomy surgery osteotomy is a surgery in which the bone is modified. The average clinical followup was 33 months and the average radiological followup with cone beam computerized tomography was. Risk factors for common complications associated with bilateral sagittal split osteotomy. About bilateral sagittal split osteotomy surgery osteotomy is a surgery in which the bone is modified. Onestage technique for sagittal split ramus osteotomy.
Stability of the mandible after bilateral sagittal split osteotomy. Surgical correction of asymmetric mandibular prognathism with modi. However, the traditional design of buccal osteotomy, located at the junction of mandibular ramus and body, may prevent more extensive sliding between the bone segments, particularly on the advance, laterality and verticality of the mandibular body. A clinical study ajoy kumar shahi1, subhash chandra2 1professor, department of oral and maxillofacial surgery, buddha institute of dental sciences and hospital, patna, bihar. Bilateral sagittal split ramus osteotomy an orthognathic surgery done at richardson dental and craniofacial hospital, nagercoil, tamilnadu, india. In 1953, the sagittal split osteotomy evolved into a procedure that could be accomplished intraorally, without transfacial approaches and without leaving visible scars. A bilateral sagittal split osteotomy bsso is a procedure used frequently for the correction of a class ii malocclusion. Translation find a translation for bilateral saggital split osteotomy jaw surgery in other languages. It was first described by trauner and obwegeser in 1957. Bilateral sagittal split osteotomy pocket dentistry. Three lateral osteotomy designs for bilateral sagittal. Complications related to mandibular advancement by bilateral. Bilateral sagittal split ramus osteotomy bssro is the most widely used mandibular surgical technique in orthognathic surgery and is easy to relocate the distal segments, accelerating bone repair by the large surface of bone contact.
The sagittal split osteotomy obwegeserdal pont bellepker procedure 6. The operation time, healing and recovery periods are shorter, which cause more convenience for both surgeon and patient. Cvideo 25 min videos of a particular surgery or technique. Sagittal split ramus osteotomy, fixation stability, orthognathic surgery introduction the sagittal split ramus osteotomy ssro is an established technique in orthognatic surgery. Three lateral osteotomy designs for bilateral sagittal split. Bilateral sagittal split osteotomy bsso is commonly used to treat mandibular discrepancies 7,11,28. Complications of bilateral sagittal split osteotomy in.
Pdf risk factors for common complications associated with. Apr 25, 2020 a sagittal split osteotomy is an oral surgery procedure that is done to correct any serious misalignment of the upper and lower teeth. Osteotomy site grafting in bilateral sagittal split. However, it can cause neurosensory dysfunction nsd or sensory loss by injury of the inferior alveolar nerve. Bilateral sagittal split osteotomy bilateral sagittal split ramus osteotomy bsso is a common mandibular orthognathic procedure. This procedure is indicated for many deformities including mandibular hypoplasia, hyperplasia, and asymmetry. Neurosensory disturbance after bilateral sagittal split osteotomy. Sagittal split osteotomy sso was described by obwegeser et al in 19551 for the correction of both prognathism and mandibular deficiency. Factors affecting the stability of bilateral sagittal.
Jan 08, 2015 the bilateral sagittal split osteotomy bsso can be considered a milestone in surgery in general. Neurosensory disturbance after bilateral sagittal split. Bilateral sagittal split osteotomy semantic scholar. After completion of the split, the distal segment was repositioned in the planned position. Pdf most of the skeletal malocclusions which require orthognathic surgeries are treated by traditional approach which requires. A bsso is performed on the lower jaw, the mandible, in order to move it forward in the case of a deficient lower jaw, or backward in the case of a large. Sorry i didnt post this yesterday, but i wasnt feeling up to it.
Complications related to mandibular advancement by. It was first described by trauner and obwegeser in 1957 2. For the bilateral sagittal split osteotomy bsso, the chin and lip position are confirmed in the supine position. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction. Bilateral ssaaggiittttaall sspplliitt oosstteeoottoommyy 25. However, a bilateral sagittal split can be more consistently fixed with. Computed tomographic analysis of the position and course of the mandibular canal. Osteotomy site grafting in bilateral sagittal split surgery. School of dental medicine, tufts university 1 kneeland st. The sagittal split osteotomy fixed with miniplates appeared to be a relatively safe and reliable procedure giving rise to a high degree of patient satisfaction, despite the fact that some occlusal. This study focuses on the evaluation of factors affecting neurosensory disturbance after bsso. Reports of bsso in a mandible, reconstructed with a nonvascularised bone.1121 1384 1390 840 1079 1559 1612 490 419 509 19 983 532 1430 746 1261 167 71 1489 1205 1 1010 252 414 1317 787 125 270 864 636 1098 1037 992 1109 742 535