Topan Cihan, Bilge Suheyb, Demirbas Ahmet Emin
Department of Oral and Maxillofacial Surgery, Erciyes University Faculty of Dentistry, Kayseri, Turkey.
Department of Oral and Maxillofacial Surgery, Erciyes University Faculty of Dentistry, Kayseri, Turkey.
J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4):102122. doi: 10.1016/j.jormas.2024.102122. Epub 2024 Oct 23.
To investigate the effect of lower border osteotomy on the lingual split pattern and IAN in BSSO procedures.
The study comprised 32 patients (64 operated sides) who underwent bilateral sagittal split osteotomy (BSSO) due to dentofacial abnormalities between the periods of April 2021 and April 2022. In the mandible, 32 sides (the conventional group) received standard BSSO surgery, while 32 sides (the modified group) additionally received lower border osteotomy. Data regarding the split difficulty of the mandibular in BSSO surgery and the recovery status of the inferior alveolar nerve (IAN) one year after surgery were obtained and evaluated from patient records. The fracture line was radiographically evaluated for the lingual split pattern following surgery.
A statistically significant difference was observed in favor of the modified group when the mandibular split difficulty of the groups was compared (p = 0.032). The split time of the modified group was found to be statistically shorter than the conventional group (p ≤ 0.001). The mean numbness level of the modified group one year after surgery was statistically significantly lower than that of the conventional group (p = 0.019). Although there was no statistically significant difference between the two groups in terms of lingual fracture pattern, the rate of type 1 (87.5 %) fracture was higher in the modified group compared to the other group (68.8 %) (p = 0.089).
The lower border osteotomy performed in addition to the conventional BSSO surgery allows the split procedure easier and in a shorter time. The modification resulted in an increased incidence of type 1 lingual fracture pattern in the mandible. The neurosensory recovery capacity of the IAN in the postoperative period is higher in areas where lower-border osteotomies are performed.
探讨下颌下缘截骨术对双侧矢状劈开截骨术（BSSO）中舌侧劈开模式及下牙槽神经（IAN）的影响。
本研究纳入了2021年4月至2022年4月期间因牙颌面畸形接受双侧矢状劈开截骨术（BSSO）的32例患者（64侧手术侧）。在下颌骨，32侧（传统组）接受标准BSSO手术，而32侧（改良组）额外接受下颌下缘截骨术。从患者记录中获取并评估BSSO手术中下颌劈开难度及术后一年下牙槽神经（IAN）的恢复情况的数据。术后通过影像学评估骨折线的舌侧劈开模式。
比较两组的下颌劈开难度时，观察到改良组具有统计学显著差异（p = 0.032）。发现改良组的劈开时间在统计学上短于传统组（p≤0.001）。改良组术后一年的平均麻木程度在统计学上显著低于传统组（p = 0.019）。尽管两组在舌侧骨折模式方面无统计学显著差异，但改良组1型骨折发生率（87.5%）高于另一组（68.8%）（p = 0.089）。
在传统BSSO手术基础上进行下颌下缘截骨术可使劈开操作更容易且时间更短。这种改良导致下颌骨1型舌侧骨折模式的发生率增加。在下颌下缘截骨的区域，术后IAN的神经感觉恢复能力更高。
