Correlation between mandibular condylar position and clinical dysfunction index after bilateral sagittal split osteotomies
Published on: 4th June, 2019
OCLC Number/Unique Identifier: 8165128692
Several articles have discussed mandibular condyle position after bilateral sagittal split osteotomies (BSSO). However, previous studies have sought to establish a relationship between orthognathic surgery and the improvement of temporomandibular joint (TMJ) signs and symptoms. Also, they have been limited to two-dimensional evaluation of condylar position considering only the condylar “sag” or improper inferior seating of the condyle. The purpose of this study was to investigate a relationship between changes in condylar position using three-dimensional computed tomography and the negative clinical impact of BSSO on the temporomandibular joint.
Bone Compactness and Bad Split in the SSO (Sagittal Split Osteotomy) of the Mandible
Published on: 14th October, 2025
Sagittal split osteotomy (SSO) of the mandible is still an important part of orthognathic surgery, but “bad split” fractures that happen during the surgery are still a big problem. This report describes a rare case of bilateral bad split associated with highly compact mandibular bone (D1–D2 type) in a 53-year-old male undergoing mandibular advancement. The bone was too hard for the piezoelectric and rotary tools to work, and there was very little bleeding. This caused fractures in the cortex and lingual. Postoperative computed tomography confirmed the presence of highly dense bone, correlated with delayed healing and recurrence. Consistent pre-surgical CT scanning for an assessment of the density of the mandibular bone can provide essential information about the potential risk of the osteotomy procedure in the patient. Performing a careful bone quality and density examination pre-operatively will allow the surgeons to select the most appropriate instruments and surgical techniques that will fit the patient’s individual anatomy. Such a point escalates to being very significant when dealing with the geriatric population, as bone density increase can not only alter the fracture behavior but also the recovery process during and after surgery. The inclusion of regular CT-based bone density evaluations into the preoperative routine not only facilitates the anticipation of surgical difficulties but also results in safer and more efficient osteotomies.
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