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Erschienen in: Aesthetic Plastic Surgery 5/2022

04.01.2022 | Original Article

Risk Factors Analysis for Different Types of Unfavorable Fracture Patterns During Sagittal Split Ramus Osteotomy: A Retrospective Study of 2008 Sides

verfasst von: Min Wang, Peiran Li, Jie Zhang, Yixin Sun, Xiaohui Zhang, Nan Jiang

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2022

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Abstract

Purpose

To summarize unfavorable fracture patterns during sagittal split ramus osteotomy (SSRO) and investigate the association with influencing factors.

Materials and Methods

We conducted a retrospective analysis of 1007 patients with 2008 sides of SSRO and classified unfavorable fracture patterns into three types: fracture lines involving the sigmoid notch, condylar process, or coronoid process (Type A); fracture lines extending from the posterior border of the mandibular ramus to the mandibular body or the anterior border of the ramus (Type B); and unfavorable fractures located in the anterior horn of the proximal segment with free fragment (Type C). Logistic regression analysis was used to evaluate factors influencing unfavorable fracture patterns, including sex, age at the time of operation, class of occlusion, presence of the third molar, uni- or bi-maxillary surgery, and the distance from the mandibular canal to the buccal cortex.

Results

The distance from the mandibular canal to the buccal cortex was significantly associated with unfavorable fracture patterns during SSRO. The presence of third molars was significantly associated with Type A fractures. The distance from the mandibular canal to the buccal cortex was significantly lower in Type B fractures.

Conclusion

We found that the influencing factors for unfavorable fracture patterns varied. Clinicians should pay specific attention to patients with factors for each unfavorable fracture pattern during SSRO.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Ferri J, Druelle C, Schlund M, Bricout N, Nicot R (2019) Complications in orthognathic surgery: a retrospective study of 5025 cases. Int Orthod 17:789–798CrossRef Ferri J, Druelle C, Schlund M, Bricout N, Nicot R (2019) Complications in orthognathic surgery: a retrospective study of 5025 cases. Int Orthod 17:789–798CrossRef
2.
Zurück zum Zitat Huang CS, Chen YR (2015) Orthodontic principles and guidelines for the surgery-first approach to orthognathic surgery. Int J Oral Maxillofac Surg 44:1457–1462CrossRef Huang CS, Chen YR (2015) Orthodontic principles and guidelines for the surgery-first approach to orthognathic surgery. Int J Oral Maxillofac Surg 44:1457–1462CrossRef
3.
Zurück zum Zitat Yu IH, Wong YK (2008) Evaluation of mandibular anatomy related to sagittal split ramus osteotomy using 3-dimensional computed tomography scan images. Int J Oral Maxillofac Surg 37:521–528CrossRef Yu IH, Wong YK (2008) Evaluation of mandibular anatomy related to sagittal split ramus osteotomy using 3-dimensional computed tomography scan images. Int J Oral Maxillofac Surg 37:521–528CrossRef
4.
Zurück zum Zitat Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 10:677–689CrossRef Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 10:677–689CrossRef
5.
Zurück zum Zitat Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47 Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47
6.
Zurück zum Zitat Hunsuck EE (1968) A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 26:250–253PubMed Hunsuck EE (1968) A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 26:250–253PubMed
7.
Zurück zum Zitat Möhlhenrich SC, Kniha K, Peters F et al (2017) Fracture patterns after bilateral sagittal split osteotomy of the mandibular ramus according to the Obwegeser/Dal Pont and Hunsuck/Epker modifications. J Craniomaxillofac Surg 45:762–767CrossRef Möhlhenrich SC, Kniha K, Peters F et al (2017) Fracture patterns after bilateral sagittal split osteotomy of the mandibular ramus according to the Obwegeser/Dal Pont and Hunsuck/Epker modifications. J Craniomaxillofac Surg 45:762–767CrossRef
8.
Zurück zum Zitat Gilles R, Couvreur T, Dammous S (2013) Ultrasonic orthognathic surgery: enhancements to established osteotomies. Int J Oral Maxillofac Surg 42:981–987CrossRef Gilles R, Couvreur T, Dammous S (2013) Ultrasonic orthognathic surgery: enhancements to established osteotomies. Int J Oral Maxillofac Surg 42:981–987CrossRef
9.
Zurück zum Zitat Guernsey LH, DeChamplain RW (1971) Sequelae and complications of the intraoral sagittal osteotomy in the mandibular rami. Oral Surg Oral Med Oral Pathol 32:176–192CrossRef Guernsey LH, DeChamplain RW (1971) Sequelae and complications of the intraoral sagittal osteotomy in the mandibular rami. Oral Surg Oral Med Oral Pathol 32:176–192CrossRef
10.
Zurück zum Zitat Mensink G, Verweij JP, Frank MD, Eelco Bergsma J, Richard van Merkesteyn JP (2013) Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients. Br J Oral Maxillofac Surg 51:525–529CrossRef Mensink G, Verweij JP, Frank MD, Eelco Bergsma J, Richard van Merkesteyn JP (2013) Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients. Br J Oral Maxillofac Surg 51:525–529CrossRef
11.
Zurück zum Zitat Steenen SA, Becking AG (2016) Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns. Int J Oral Maxillofac Surg 45:887–897CrossRef Steenen SA, Becking AG (2016) Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns. Int J Oral Maxillofac Surg 45:887–897CrossRef
12.
Zurück zum Zitat Plooij JM, Naphausen MT, Maal TJ et al (2009) 3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible. Int J Oral Maxillofac Surg 38:1244–1249CrossRef Plooij JM, Naphausen MT, Maal TJ et al (2009) 3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible. Int J Oral Maxillofac Surg 38:1244–1249CrossRef
13.
Zurück zum Zitat Chrcanovic BR, Freire-Maia B (2012) Risk factors and prevention of bad splits during sagittal split osteotomy. Oral Maxillofac Surg 16:19–27CrossRef Chrcanovic BR, Freire-Maia B (2012) Risk factors and prevention of bad splits during sagittal split osteotomy. Oral Maxillofac Surg 16:19–27CrossRef
14.
Zurück zum Zitat Steenen SA, van Wijk AJ, Becking AG (2016) Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors. Int J Oral Maxillofac Surg 45:971–979CrossRef Steenen SA, van Wijk AJ, Becking AG (2016) Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors. Int J Oral Maxillofac Surg 45:971–979CrossRef
15.
Zurück zum Zitat Kriwalsky MS, Maurer P, Veras RB, Eckert AW, Schubert J (2008) Risk factors for a bad split during sagittal split osteotomy. Br J Oral Maxillofac Surg 46:177–179CrossRef Kriwalsky MS, Maurer P, Veras RB, Eckert AW, Schubert J (2008) Risk factors for a bad split during sagittal split osteotomy. Br J Oral Maxillofac Surg 46:177–179CrossRef
16.
Zurück zum Zitat Doucet JC, Morrison AD, Davis BR et al (2012) The presence of mandibular third molars during sagittal split osteotomies does not increase the risk of complications. J Oral Maxillofac Surg 70:1935–1943CrossRef Doucet JC, Morrison AD, Davis BR et al (2012) The presence of mandibular third molars during sagittal split osteotomies does not increase the risk of complications. J Oral Maxillofac Surg 70:1935–1943CrossRef
17.
Zurück zum Zitat Szucs A, Bujtár P, Sándor GK, Barabás J (2010) Finite element analysis of the human mandible to assess the effect of removing an impacted third molar. J Can Dent Assoc 76:a72PubMed Szucs A, Bujtár P, Sándor GK, Barabás J (2010) Finite element analysis of the human mandible to assess the effect of removing an impacted third molar. J Can Dent Assoc 76:a72PubMed
18.
Zurück zum Zitat Yoshioka I, Tanaka T, Habu M et al (2012) Effect of bone quality and position of the inferior alveolar nerve canal in continuous, long-term, neurosensory disturbance after sagittal split ramus osteotomy. J Craniomaxillofac Surg 40:e178-183CrossRef Yoshioka I, Tanaka T, Habu M et al (2012) Effect of bone quality and position of the inferior alveolar nerve canal in continuous, long-term, neurosensory disturbance after sagittal split ramus osteotomy. J Craniomaxillofac Surg 40:e178-183CrossRef
19.
Zurück zum Zitat Yoshioka I, Tanaka T, Khanal A et al (2010) Relationship between inferior alveolar nerve canal position at mandibular second molar in patients with prognathism and possible occurrence of neurosensory disturbance after sagittal split ramus osteotomy. J Oral Maxillofac Surg 68:3022–3027CrossRef Yoshioka I, Tanaka T, Khanal A et al (2010) Relationship between inferior alveolar nerve canal position at mandibular second molar in patients with prognathism and possible occurrence of neurosensory disturbance after sagittal split ramus osteotomy. J Oral Maxillofac Surg 68:3022–3027CrossRef
20.
Zurück zum Zitat Aarabi M, Tabrizi R, Hekmat M, Shahidi S, Puzesh A (2014) Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy. J Oral Maxillofac Surg 72:2508–2513CrossRef Aarabi M, Tabrizi R, Hekmat M, Shahidi S, Puzesh A (2014) Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy. J Oral Maxillofac Surg 72:2508–2513CrossRef
Metadaten
Titel
Risk Factors Analysis for Different Types of Unfavorable Fracture Patterns During Sagittal Split Ramus Osteotomy: A Retrospective Study of 2008 Sides
verfasst von
Min Wang
Peiran Li
Jie Zhang
Yixin Sun
Xiaohui Zhang
Nan Jiang
Publikationsdatum
04.01.2022
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2022
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02742-1

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