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Correlation between mandibular anatomy and bad split occurrence during bilateral sagittal split osteotomy: a three-dimensional study

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Abstract

Objectives

This study aimed to find out the correlation between different anatomical parameters of the mandible and the occurrence of a bad split in patients who had undergone bilateral split sagittal ramus osteotomy (BSSRO).

Materials and method

At both the distal roots of the first molar (1) and the retromolar area (2), we measured the distance from the buccal margin of the inferior dental canal (IDC) to the buccal margin of the cortical bone (MCBC), the thickness of both buccal cortical (WBCB) and cancellous bone (WBCA), distance from the superior border of IDC to the alveolar crest (MCAC), buccolingual thickness (BLT), and thickness of cancellous bone (WCA). At the ramus, the distances between the sigmoid notch to the upper part of the lingula (SL) and the inferior border of the mandible (SIBM), the thickness of the ramus at the level of the lingula (BLTR), and the anteroposterior width of the ramus (APWR) were measured. The paired and independent t-tests were used when applicable, and a P-value < 0.05 was considered significant.

Results

MCBC1 showed a significant difference between bad and non-bad split sides (P = 0.037). Both WBCA1 and WBCA2 show the same significant difference (P = 0.023, 0.024). Similarly, WCA1 and WCA2 showed a statistical difference between the bad and non-bad split sides (P = 0.027, 0.036). There were no statistically significant differences between the compared sides of WBCB1, WBCB2, MCAC1, MCAC2, SIBM, APWR, SL, and BLTR.

Conclusion

Narrow space between IDC and the buccal cortical margin, along with the decrease in the thickness of both buccal cancellous bone and total cancellous bone at the inferior border of the mandible along the course of SSRO, has been implicated in the occurrence of bad split intraoperatively.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (81901026) and the Department of Science and Technology of Sichuan Province (2021YFH0139).

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Authors and Affiliations

  1. State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China

    Wael Telha, Bassam Abotaleb, Jie Zhang, Rui Bi, Songsong Zhu & Nan Jiang

Authors
  1. Wael Telha
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  2. Bassam Abotaleb
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  3. Jie Zhang
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  4. Rui Bi
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  5. Songsong Zhu
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  6. Nan Jiang
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Contributions

Wael Telha: Conceptualization, data collection, data curation, anthropometric measurements, statistical analysis, writing—original draft preparation, review, and editing.

Bassam Abotaleb: Conceptualization, statistical analysis, review, and editing.

Jie Zhang: Data curation, methodology, reviewing.

Rui Bi: Conceptualization, statistical analysis, review, and editing.

Songsong Zhu: Conceptualization, reviewing and editing, project administration, supervision.

Nan Jiang: Conceptualization, project administration, reviewing and editing, supervision.

Corresponding authors

Correspondence to Songsong Zhu or Nan Jiang.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This research was approved by the institutional review board of West China Stomatology Hospital Sichuan University (WCHS-IRB-CT-2019–221). Patients’ permission was obtained.

Conflict of interest

The authors declare no competing interests.

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Telha, W., Abotaleb, B., Zhang, J. et al. Correlation between mandibular anatomy and bad split occurrence during bilateral sagittal split osteotomy: a three-dimensional study. Clin Oral Invest 27, 1035–1042 (2023). https://doi.org/10.1007/s00784-022-04665-w

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