Evaluation of the Mandibular Split Patterns in Sagittal Split Ramus Osteotomy

Hou, Min; Yu, Tianping; Jian-guo, Wang

doi:10.1016/j.joms.2014.07.007

Cited by 18 publications

(10 citation statements)

References 11 publications

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“…The Hunsuck and Epker modification, on the other hand, involves an incomplete lingual osteotomy that terminates just behind the lingula and inferior alveolar canal. This modification is notably easier compared to the conventional lingual osteotomy, which traditionally extends to the posterior border of the ramus and may occasionally result in unfavourable split fractures [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Al-Dawoody,

Hamad,

Kheder Khrwatany

et al. 2023

Head Face Med

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Aim The purpose of this study was to evaluate the effect of adding a fourth osteotomy at the lower border of the mandible on the lingual cortical fracture pattern in bilateral sagittal split ramus osteotomies. Patients and methods The sample of the study consisted of 20 patients (12 male and 8 female, with a mean age of 26.79 ± 7.12 years) with mandibular deformities who needed bilateral sagittal split ramus osteotomy. One side underwent a traditional sagittal split ramus osteotomy, and the procedure was modified on the other side by adding a 1 cm horizontal osteotomy at the lower border of the mandible, just distal to the caudal end of the vertical buccal osteotomy cut. A 3D CBCT was used to identify the split pattern. Results In the total sample, 40% of the lingual splits ran vertically toward the lower border of the mandible (LSS1), 20% of the splits passed horizontally to the posterior border of the mandible (LSS2), 32.5% of the splits took place along the inferior alveolar canal (LSS3), and 7.5% of the splits were unfavourable fractures (LSS4). On the inferior border osteotomy sides, the distribution of LSS1, LSS2, LSS3, and LSS4 was 10 (25%), 6 (15%), 4 (10%), and 0 (00), respectively. Their distribution on the sides without inferior border osteotomy was 6 (15%), 8 (20%), 13 (32.5%), and 3 (7.5%), respectively. Statistical analysis revealed a significant difference between the two groups (p < 0.05). Conclusion Inferior border osteotomy tends to direct the lingual split fracture line toward the lower and posterior borders of the mandible and minimizes bad splits; however, further studies are needed to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Al-Dawoody,

Hamad,

Kheder Khrwatany

et al. 2023

Head Face Med

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show abstract

“…The shape of the osteotomy was asymmetric at different levels of the proximal tibia, with an average coverage of 80.62% to 84.73%. 29 After our study assessed that a middle diameter of 60 to 80 mm and an anteroposterior diameter of 40 to 55 mm of the tibial prosthesis is more suitable for Chinese people, and a design was recommended that was consistent with the proximal tibial shape in Chinese people. Research and clinical application to women and asymmetric prostheses to reduce the phenomenon of prosthesis mismatch and improve the excellent rate of knee replacement surgery is increasing.…”

Section: Discussionmentioning

confidence: 99%

“…The shape of the osteotomy was asymmetric at different levels of the proximal tibia, with an average coverage of 80.62% to 84.73%. 29…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the application value of a three-dimensional digital model of the knee in clinical practice

Keremu¹,

Mijiti²,

Mijiti³

et al. 2020

J Int Med Res

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Objective To compare the knee shape and bone parameters between knee prosthesis products from overseas companies and a Chinese patient’s knee, and to apply the anatomical basis for Chinese knee prosthesis design. Methods Three-dimensional digital models were built, including prosthesis products for a normal adult. The relevant anatomy index was measured, and physical parameter, radiographic, geometric, knee kinematic, and distal geometry data were collected on the femur and tibia. Results The width of the femoral condyle (WFC), width of the medial femoral condyle (WMFC), width of the lateral femoral condyle (WLFC), depth of the intercondylar fossa (DICF), sagittal length of the medial femoral condyle (SLMFC), sagittal length of the lateral femoral condyle (SLLFC), angle of the medial femoral condyle (AMFC), and angle of the lateral femoral condyle (ALFC) in the femur and the transverse diameter (ML) and anteroposterior diameter (AP) of the tibial bone were measured. These parameters were significantly lower in the normal group compared with the prosthesis product model group. Conclusion When using an imported knee prosthesis, the osteotomy angle may not fit perfectly. Use of an imported prosthesis may be an important factor in the increasing failure of knee arthroplasty in China.

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“…Several studies have highlighted the influence of bone thickness and height of the posterior mandible on the split pattern and the incidence of operative complications. [18][19][20][21] It was found that a slender and thin mandible with short ramus height and body depth carries a higher risk of unfavorable fractures. 18,21 The biggest concern about bad split in these cases emerges from the compromised bone contact and extensive periosteal dissection that is necessary for the fragment salvage and fixation, resulting in an increased risk of bone ischemia and sequestration.…”

Section: Discussionmentioning

confidence: 99%

Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery

Alalawy

Kadhum

Abdulnabi

2022

Craniomaxillofacial Research & Innovation

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Study Design Case Report. Objective To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result. Method A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage. Results On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship. Conclusion Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

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Evaluation of the Mandibular Split Patterns in Sagittal Split Ramus Osteotomy

Cited by 18 publications

References 11 publications

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Does osteotomizing the lower border of the mandible affect the lingual split pattern in a sagittal split ramus osteotomy?

Evaluation of the application value of a three-dimensional digital model of the knee in clinical practice

Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery

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