Technical note| Volume 58, ISSUE 2, P240-242, February 2020

Adaptation of an osteotome to produce a predictable sagittal split ramus osteotomy

  • K. Matsushita
    Tel./Fax: +81 11 706 4283.
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo, Hokkaido 060-8586, Japan
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Published:December 18, 2019DOI:
      When using an osteotome (as opposed to a technique using a spreader) for bilateral sagittal split osteotomy, it is important to separate the buccal cortex from the intramedullary bone (involving the inferior alveolar neurovascular bundle) before the split by twisting the osteotome).
      • Bell W.H.
      • Hall H.D.
      • White R.P.
      • et al.
      Sagittal Split ramus osteotomy.
      A thin sharp osteotome is usually malleted into the groove created on the buccal shelf, and the junction is separated in advance. During malleting, particular care should be taken not to damage or transect the neurovascular bundle because it is close to this junction, and the buccal shelf is narrow. Braces on the buccal side of the teeth will occasionally obstruct the desirable insertion of the blade. To deal with such situations, I have introduced a modified osteotome and have obtained satisfactory outcomes.


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        • Bell W.H.
        • Hall H.D.
        • White R.P.
        • et al.
        Sagittal Split ramus osteotomy.
        in: Bell W.H. Proffit W.R. White R.P. Surgical correction of dentofacial deformities. WB Saunders, 1980: 898-901