Factors affecting the stability of bilateral sagittal split osteotomy of a mandible.

TLDR

Stability after bilateral sagittal split osteotomy is crucial, with relapse classified as early surgical displacement or long‑term condylar resorption that reduces mandibular height. The article reviews factors that influence the stability of BSSO outcomes. The review focuses on four fixation methods—rigid intermaxillary fixation, osteosuture, osteosynthesis, and biodegradable materials—to stabilize bone fragments. The authors discuss the advantages and disadvantages of each fixation technique in clinical practice.

Abstract

Stability of bilateral sagittal split osteotomy (BSSO) is an important goal for every surgeon. In the article factors influencing stability of the surgery result are reviewed. Special emphasis is given to different types of fixation of bone fragments. Their advantages and disadvantages in clinical use are discussed. Relapse after BSSO is usually classified as early and long-term relapse. Early relapse is usually caused by movements at the osteotomy site or temporomandibular joint sag and should be called surgical displacement. Long term relapse happens due to the progressive temporomandibular joint condylar resorption, which causes a lost of condylar and mandibular ramus height. Four different types of fixation were described in orthognatic surgery: rigid intermaxillary fixation, osteosuture, osteosynthesis and fixation with biodegradable materials.