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).
1A 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.
- 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
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- Sagittal Split ramus osteotomy.in: Bell W.H. Proffit W.R. White R.P. Surgical correction of dentofacial deformities. WB Saunders, 1980: 898-901
Published online: December 18, 2019
Accepted: November 7, 2019
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.