The Short Split Method: A Solid Alternative to Classical Sagittal Split Osteotomy in Orthognathic Surgery: A Case Report

Residents' journal review

Residents' journal review

The Effect of Orthognathic Surgery on Temporomandibular Joint Function and Symptoms: What are the Risk Factors? A Longitudinal Analysis of 375 Patients

Revisiting the Supraforaminal Horizontal Oblique Osteotomy of the Mandible

Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review

Context: Using a reliable fixation method after ramus sagittal split osteotomy in order to reduce the chances of treatment relapse and condyle changes is still one of the most noteworthy issues discussed among maxillofacial surgeons. In this study, the results of the up-to-date papers were collected, which identify the eects of the fixation method on the post-operative results, to give the reader a comprehensive view of the new concepts. Evidence Acquisition: The most frequent mandibular surgeries, setbacks, and advancements via the bilateral sagittal split os- teotomy technique were used for a literature search due to the abundance of related articles. Consequently, the following keywords were applied: sagittal split ramus osteotomy, orthognathic surgery, rigid fixation, non-rigid fixation, postoperative relapse, and postoperative stability. Results: The articles were classified according to the surgery procedure: mandibular advancement surgery or mandibular setback surgery. The relapse pattern can be divided into two categories: an early relapse, which is strongly related to the surgery proce- dure, and a late relapse, which can be attributed to the physiologic changes, such as a growth map. The contributing factors can be considered to be the following: a change in ramus in inclination, the mandibular plane, and the fixation type. Conclusions: Using rigid fixation techniques after bilateral sagittal split ramus osteotomy will optimize the stability, but this sta- bility is not influenced by the method of this rigid fixation; although the most commonly suggested technique, bicortical screws, is in the inverted-L position

Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction

Influence of inferior border cut on lingual fracture pattern during bilateral sagittal split osteotomy with splitter and separators: Aprospective observational study.

Chapter 2 The modifications of the sagittal ramus split osteotomy: a literature review Chapter 3 Pilot study of modification of the bilateral sagittal split osteotomy (BSSO) in pig mandibles Chapter 4 Modification of the bilateral sagittal split osteotomy (BSSO) in a study using pig mandibles Chapter 5 In-vitro comparison of the sagittal split osteotomy with and without inferior border osteotomy Chapter 6 An in-vitro comparison study of the use of a drill or a saw in the Hunsuck-Dal Pont modification of the Obwegeser sagittal split osteotomy in pig mandibles Chapter 7 Lingual fracture patterns of the mandible split in humans using the inferior border osteotomy -preliminary results Chapter 8 Discussion and future perspectives Valorisation

Residents' journal review

Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism

Qualitative Descriptors Used by Patients Following Orthognathic Surgery to Portray Altered Sensation

The trigeminocardiac reflex (TCR) is a rare but clinically significant phenomenon characterized by bradycardia, hypotension, or asystole triggered by trigeminal nerve stimulation during maxillofacial surgery. It necessitates prompt recognition and management to ensure patient safety. TCR has been reported in orthognathic surgery, particularly during specific surgical maneuvers. We report the case of a 36-year-old male who experienced TCR during bimaxillary orthognathic surgery. Detailed documentation of the patient's clinical characteristics, intraoperative events, and management strategies was included. Additionally, we conducted a systematic review of the literature using Medline, Embase, Web of Science, and Scopus databases to identify cases of TCR in orthognathic surgery published from 1989 onward. Keywords included "trigeminocardiac reflex," "orthognathic surgery," "Le Fort I," and "bilateral sagittal split osteotomy". We present the case of a patient who experienced transient bradycardia and asystole during mandibular manipulation and pterygomaxillary disjunction. The episode was successfully managed with atropine and cessation of triggering maneuvers. Additionally, a systematic review identified 10 cases of TCR in orthognathic surgery, most of which occurred during Le Fort I osteotomies, particularly during maxillary downfracture, followed by bilateral sagittal split osteotomies. Common manifestations included bradycardia and asystole. Management strategies involved cessation of surgical stimuli, administration of anticholinergic agents, and, in one severe case, cardiopulmonary resuscitation. TCR in orthognathic surgery is a significant risk requiring vigilance and prompt management. Understanding its triggers, maintaining intraoperative monitoring, and employing preventive strategies, such as gentle manipulation and proper anesthesia protocols, are essential for optimizing patient safety.

Risk factors of nerve injury during mandibular sagittal split osteotomy

Purpose: The purpose of this study was to compare the changes in the pharyngeal airway space, tongue and hyoid bone positions according to the orthognathic surgical methods of mandibular prognathism. Methods: The subjects included 30 patients (16 males, 14 females) with the skeletal class III malocclusion. Group 1 (10 patients) underwent bilateral sagittal split ramus osteotomy (BSSRO) only; group 2 (10 patients) underwent BSSRO with genioplasty; and group 3 (10 patients) underwent BSSRO, Le Fort I osteotomy. We measured the lines between the selected upper air way, hyoid bone and tongue landmarks on the lateral cephalometric x-ray films of skeletal class III. The measurements were made preoperation, within 1 week after the operation, 3~6 months after the operation and 1 year after the operation. We compared and analyzed the measurements with matched paired t-test and independent samples t-test. Results: There were no postoperative changes in the nasopharyngeal airway space in group 3. The measurements of group 3 also increased during the follow-up period as compared to the preoperative measurements. In group 1, 2 and 3, the immediate postoperative oropharyngeal and hypopharyngeal airway spaces were decreased. In the following period, the hypopharyngeal airway space returned to the preoperative positions, but the oropharyngeal airway space was not significantly changed. The upper and lower tongue was posteriorly repositioned immediately after the surgery. During the follow-up period, the lower tongue position returned to the preoperative position, and the upper tongue position was not significantly changed. Immediately after the surgery, the B point was moved to the posterior position, and a slight anterior advancement was found in the follow-up period. Conclusion: Patients who received the mandibular setback surgery showed a decrease in the posterior airway space, and those who underwent maxillary advancement showed a significant increase of the nasopharyngeal airway space, which remained stable during the evaluation period. The change of the airway space, position of the hyoid bone and tongue did not differ according to the presence or absence of genioplasty.