The proximal segment in sagittal split ramus osteotomy
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Abstract
Bilateral sagittal split ramus osteotomy is one of the most versatile techniques in orthognathic surgery that allows for the repositioning of the mandible in all directions. This osteotomy splits the mandible into two proximal condyle-bearing segments and one distal tooth-bearing segment.Intraoperatively, the surgeon is usually focused primarily on the proper positioning of the distal segment to achieve the planned amount of advancement or setback. However, particular attention should be paid to the position of the proximal segment, as improper positioning of the proximal segment during fixation gives rise to immediate or late relapse of the surgical outcomes. The goal of this paper is to provide some background knowledge about the proximal segment for the novice surgeons, based on a review of the relevant literature. What is the proper position of the proximal segment, and what is the best technique to guide the proximal segment into its proper position?. These questions do not have clear-cut answers that the majority of surgeons agree on.
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2. Ueki K, Moroi A, Sotobori M, Ishihara Y, Marukawa K, Takatsuka S, Yoshizawa K, DDS, Kato K, Kawashiri S. (2012) A hypothesis on the desired postoperative position of the condyle in orthognathic surgery: a review. Oral Surg Oral Med Oral Pathol Oral Radiol 114: 567-576. DOI: 10.1016/j.oooo.2011.12.026.
3.Costa F, Robiony M, Toro C, Sembronio S, Polini F, Politi M. (2008) Condylar positioning devices for orthognathic surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106: 179-190. DOI: 10.1016/j.tripleo.2007.11.027.
4.Luhr H-G. (1989) The significance of condylar position using rigid fixation in orthognathic surgery. Clin Plast Surg 16: 147-156.
5.Gerressen M, Stockbrink G, Smeets R, Ghassemi A. (2007) Skeletal Stability Following Bilateral Sagittal Split Osteotomy (BSSO) With and Without Condylar Positioning Device. J Oral Maxillofac Surg 65: 1297-1302. DOI: 10.1016/j.joms.2006.10.026.
6.Ellis E. (1994) Condylar Positioning Devices For Orthognathic Surgery: Are They Necessary? J Oral Maxillofac Surg 52: 536-552.
| Files | ||
| Issue | Vol 9, No 1 (Winter 2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v9i1.11079 | |
| Keywords | ||
| Orthognathic surgery Osteotomy Mandibular condyle Proximal segment Sagittal split | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sharifi R, Beshkar M, Shirani G. The proximal segment in sagittal split ramus osteotomy. J Craniomaxillofac Res. 2022;9(1):19-22.
