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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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First, a horizontal cut is made on the inner side of the ramus mandibulaeextending anterally to the anterior portion of the ascending ramus. BSSO Lower Jaw Surgery 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.

Retrieved from ” https: Cutting one bone is known as an osteotomywhile performing the surgery on both jaws simultaneously is known as a bi-maxillary osteotomy cutting the bone of both jaws or a maxillomandibular advancement. Prior to the procedure, the orthodontist has an orthopedic appliance attached to the maxilla teeth, bilaterally, extending over the palate with an attachment so the surgeon may use a hex-like screw to place into the device to push from anterior to posterior to start spreading the bony segments.

Orthognathic Surgery Orthognathic surgery involves correcting jaws that do not meet correctly, or teeth that do not align properly. Orthognathic surgery allows for the repositioning of teeth and facial bones to create a jaw that works and functions properly, and has a more balanced appearance.

Dentofacial osteotomy is usually performed using oscillating and reciprocating saws, burs, and manual chisels. These ensure we achieve highly complex surgical movements, with results that have excellent predictability and stability. If the jaw is sometimes immobilized movement restricted by wires or elastics for approximately 1—4 weeks. Advancements allow surgeons to expand the use of an osteotomy on more parts of the jaws with faster recovery time, less pain, and no hospitalization, making the surgery more effective with respect to time and recovery.

Immediately after surgery, patients must adhere to certain infection preventing instructions such as daily cleaning, and the consumption of antibiotics.

An important component of orthognathic surgery is the bilateral sagittal split osteotomy BSSOwhich is the most commonly performed jaw surgery, either with or without upper jaw surgery. Retromolar osteotomy for the correction of prognathism. The data indicated that getting the osteotomy and the third molar extraction at the same time highly increases the chances of infection development. Depending on their cosmetic needs, many patients benefit from chin implants.


Modifications in the sagittal osteotomy of the mandible. Many surgeons prefer this procedure for the correction of a dentofacial deformity due to its effectiveness.

This consists of the surgeon making horizontal cuts on the lateral board of the maxillaextending anterally to the inferior border of the nasal cavity.

Prior to this, surgeons would fully sedate patients, hospitalizing them shortly after the surgery for a day recovery, specifically from the anesthesia. Patients were reviewed, and divided into two groups; those who had, and those who didn’t have their third molars extracted during the dentofacial Osteotomy.

Now the mandible is placed in its desired position with the aid of the prefabricated splint and any intervening bone is removed if performing a mandibular setback. Effects of age, amount of advancement, and genioplasty on neurosensory disturbance after a bilateral sagittal split osteotomy.

The recent advent of piezoelectric saws has simplified bone cutting, but such equipment has not yet become the norm outside of the most developed countries.

Orthognathic Surgery

The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities. A cuff of tissue should be preserved medial to the incision to facilitate closure.

The surgery usually results in a noticeable change in the patient’s face; a psychological assessment is occasionally required to assess patient’s need for surgery and its predicted effect on the patient. Plates and screws are then applied to allow bone to grow and heal naturally.

BSSO | Lower Jaw Advancement Surgery » Profilo° Surgical

The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of the bilateral sagittal split osteotomy to fully understand the procedure and to counsel the patient. However, several cases have been reported in the literature. This procedure generally takes about 30 minutes to perform, and patients are usually able to return to work and other regular activities the next day.

When the midface has a deformity, this procedure may be performed. 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 Relationship between mandible and maxilla. The cut is then made inferiorly on the ascending ramus to the descending ramusextending to the lateral border of the mandible in the area between the first and second molar. Plates and screws are inserted to allow bone to grow and heal naturally. Long term follow-up of the sagittal splitting technique for correction of mandibular prognathism. Once the osteotomy is complete, check that each segment is free of the other and that the condylar head is still attached to the proximal segment.

The maxilla can be adjusted using a ” Lefort I ” level osteotomy sugery common. The nasal tube enables the teeth to be wired together during surgery. Complications Complications related to BSSO include bleeding from injury to the inferior alveolar artery or masseteric artery, unanticipated fractures and unfavorable splits, avascular necrosis, condylar resorption, malposition of the proximal segment, and worsening of temporomandibular joint TMJ symptoms.

Lastly, the jaw is stabilized beso stabilizing screws that are inserted extra-orally.

Your teeth may need to be orthodontically aligned before undergoing Lower Jaw Surgery. Impacted third molars are another cause of unfavorable fractures and should ideally be removed 6 months to 1 year prior to mandibular surgery. R Colcleugh, was used to identify threats of combining the two surgeries used 83 patients from the time span of and Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: A Kocher clamp with a chain is then placed on the coronoid process surgdry secured to the surgical drape.

For this procedure cuts are made behind the molarsin between the first and second molarsand lengthwise, detaching the front of the jaw vsso the palate including beso teeth and all can move as one unit. A modified intraoral sagittal splitting technic for correction of mandibular prognathism.

Radiographs and photographs are taken to help in the planning.

LeFort II osteotomies aim to correct growth abnormalities in the midface, and problems such as sleep apnea or malocclusions. The incision is continued through submucosa, muscle, and periosteum with electrocautery. The risk of injury to the inferior alveolar nerve is a significant consideration when performing a BSSO.