February 6, 2019


Orthognathic surgery); also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and face related to. Faculty of Dental Medicine Al-Azhar UniversityOrthognathic surgery is the Bilateral sagittal split osteotomy (BSSO) has a wide range of. Mandibular osteotomies in Orthognathic Surgery Mandibular Recently good stability after BSSO is also shown by polylactate bone plates and.

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Workup Standardized photos are required not only for documentation and photometric analysis, but for evaluation of outcomes as well. Then, the jaw is stabilized using titanium screws that will eventually be grown over by bone, permanently staying sufgery the mouth.

The jaws will be wired together inter-maxillary fixation using stainless steel wires during the surgery to ensure the correct re-positioning of the bones. In most cases, these wires are released before the patient wakes up. Some procedures will call for the insertion of implants to give the patient’s face a fuller look. An extensive study done by Dr. LeFort surgery, depending on the type, can correct a host of problems, including a face that appears too long or too short, a “gummy” smile, and over- or underbites.

J Plast Reconstr Aesthet Surg. Plates and screws are inserted to allow bone to grow and heal naturally. MonsonMD 1. A J-stripper is then inserted along the inferior border of the mandible and all attachments are released.

BSSO | Lower Jaw Advancement Surgery » Profilo° Surgical

While many patients can achieve an ideal facial structure with BSSO alone, others choose to undergo an additional chin procedure called genioplasty. The numbness may be either temporary, or more rarely, permanent. Orthognathic Surgery Orthognathic surgery involves correcting jaws that do not meet correctly, or teeth that do not align properly. The surgical correction of mandibular prognathism and retrognathia with shrgery of genioplasty.


Relationship between mandible and maxilla. All of the cuts are then checked to ensure that they are complete through the cortex and down to cancellous bone. The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities.

BSSO | Lower Jaw Surgery » Profilo° Surgical

Depending on each surgeon’s training and preference, this cut can be made with the reciprocating saw or with a fissure bsxo. The data indicated that getting the osteotomy and the third molar extraction at the same time highly increases the chances of infection development. Decreased mobility after surgsry BSSO is not an uncommon postoperative problem. A small lower jaw and chin aren’t merely a cosmetic issue, but are likely to be a sign of snoring, sleep apnoea and disturbed chewing function.

Journal of Cranio-Maxillofacial Surgery.

Bilateral Sagittal Split Osteotomy

The osteotomes progress wurgery anterior to posterior completing the cut. Guiding elastics can be placed intraoperatively or postoperatively following extubation. International Surgrry of Oral and Maxillofacial Surgery. Once the pedicle is adequately protected, a channel retractor is inserted to provide lateral retraction, a Kocher is placed to provide superior retraction, and a reciprocating saw is placed medial to the ascending ramus, superior to the lingula and parallel to the occlusal plane.

Common analyses include Steiner, Ricketts, and Delaire; however, these are beyond the scope of this overview.

Radiographs and photographs are taken to help in the planning. This procedure is used for the advancement movement forward or retraction movement backwards of the chin.

Address for correspondence Laura A. Care must be taken as to not injure the inferior palatine artery.

BSSO | Lower Jaw Surgery

The bssso several decades would see improvements and modifications to the procedure with the focus on decreasing relapse, improving healing, and decreasing complications. It is important that this cut is made completely through the cortical bone along the inferior border.


If the jaw is sometimes immobilized movement restricted by wires or elastics for approximately 1—4 weeks. An osteotomy is any procedure in which a bone is cut in order to reposition it or change its length. As the split is opening, check the position of the inferior alveolar nerve, if it is hung up either on the lateral or proximal segment, use a blunt elevator to gently release it. Diagnostic value of clinical and electrophysiologic tests in the follow-up”.

Treatment There are several determinants of the optimal modification for BSSO in an individual patient, including the position of the mandibular foramen lingualcourse of the inferior alveolar nerve in the mandible, presence of the mandibular third molars, and planned direction and magnitude of distal segment movement.

Orthognathic surgery and a tale of how three procedures came to be: Since the modern era of screw fixation, the incidence of lingual nerve injury has declined and become an uncommon complication following a BSSO. A periosteal elevator is used to dissect all of the tissue along the buccal surface of the ramus and the proximal mandibular body. The two segments are then fixated according to the surgeon’s preference with either three bicortical screws on either side or srgery a miniplate with three holes on either side of the osteotomy.

It is important to make sure that each one is complete surgeery to the channel retractor below and that no twisting forces are utilized to prevent a surggery split. A small elevator is placed along the medial aspect of the ramus and is utilized to retract and protect the pedicle.