Orthognathic surgery); also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and face related to. Faculty of Dental Medicine Al-Azhar UniversityOrthognathic surgery is the Bilateral sagittal split osteotomy (BSSO) has a wide range of. Mandibular osteotomies in Orthognathic Surgery Mandibular Recently good stability after BSSO is also shown by polylactate bone plates and.

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Chewing becomes problematic, and may also cause pain due to straining of the jaw muscle and bone. Long term follow-up of nsso sagittal splitting technique for correction of mandibular prognathism.

Surgical specialties Jaw surgery. MonsonMD 1. M Lacy and Dr.

Three lateral osteotomy designs for bilateral sagittal split osteotomy: A horizontal incision is then made inferior to the first bicuspidsbilaterally, where bone cuts osteotomies are made vertically inferior, extending to the inferior border of the mandiblethereby detaching the bony segments of the mandible. Doctors will prescribe pain medication and prophylactic antibiotics to the patient.

Complications related to BSSO include bleeding from injury to the inferior alveolar artery or masseteric artery, unanticipated fractures and unfavorable splits, avascular necrosis, condylar resorption, malposition of the proximal segment, and worsening of temporomandibular joint TMJ symptoms.

Prior to a “sliding genioplasty,” an incision is made behind the lower lip. Decreased mobility after a BSSO is not an uncommon postoperative problem. Hullihen and the origin of orthognathic surgery. Prior to the procedure, an orthodontist applies dental braces to ensure the teeth will be properly aligned following surgery.

Bilateral Sagittal Split Osteotomy

While many patients can achieve an ideal facial structure with BSSO alone, others choose to undergo an additional chin procedure called genioplasty. Address for correspondence Laura A. Once the teeth are aligned, durgery patient is ready for the BSSO. The original mandible and maxilla osteotomy procedure still remains almost unchanged, as it is the simplest and still the most effective for dentofacial eurgery correction.


Proximal segment fractures occur most often as a result of failure to completely cut the inferior border; this results in a fracture line that propagates along the buccal side of the inferior border.

This page was last edited on 4 Novemberat Ortho-Panorex X-rays provide an overview of the stage of dental development, the mandibular anatomy, and gross pathology. Prior tosome bswo undergoing a dentofacial osteotomy still had third molars wisdom teethand had them removed during surgery. Patients were reviewed, and divided into two groups; those who had, and those who didn’t have their third molars extracted during the dentofacial Osteotomy.

These techniques are utilized extensively for children that suffer from usrgery craniofacial abnormalities, such as Crouzon syndrome.

Dissection is carried down to the inferior border of the mandibular body and the posterior border of the ramus. The final cut is then made vertically along the buccal cortex at the level of the second molar down to the inferior border of the mandible.

During this surgery, the upper jaw, as well as some of the facial bone, is repositioned. Workup Standardized photos are required not only for documentation and photometric analysis, but for evaluation of outcomes as well. Then, the jaw is stabilized using titanium screws that will eventually be grown over by bone, permanently staying in the mouth.

As the split is opening, check the position of the inferior alveolar nerve, if it is hung up either on the lateral or proximal segment, use a blunt elevator to gently release it.

Also, a total maxilla osteotomy is used to treat the “long face syndrome,” known as the skeptical open bite, idiopathic long face, hyper divergent face, total maxillary alveolar hyperplasia, and vertical maxillary excess. Many patients opt for a genioplasty following suegery other surgeries. When an impacted third molar must be removed at the time of surgery, care should be taken to not use excessive force.


The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of hsso bilateral sagittal split osteotomy to bsso understand the procedure and to surgdry the patient.

This new method was an applied concept from orthopedic trauma surgery. The osteotomy is then finished with small curved osteotomes, taking care to direct the curve buccally and to protect the soft tissues with a channel retractor. First, a horizontal cut is made on the inner side of the ramus mandibulaeextending anterally to the anterior portion of the ascending ramus.

BSSO | Lower Jaw Surgery

The surgery usually does not involve cutting the skin. From here, the mandible can be moved either forwards or backwards. Orthognathic surgery allows for the repositioning of teeth and facial bones to create a jaw that works and functions properly, and has a more balanced appearance. This allows you to visualise the outcome of your surgical procedure before you decide to proceed with treatment. The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities.

The surgery usually results in a noticeable change in the patient’s face; a psychological assessment is occasionally required to assess patient’s need for surgery and its predicted effect on the patient. All of the cuts are then checked to ensure that they are complete through the cortex and down to cancellous bone.