AÇBİD 15th İnternational Congress, Antalya, Türkiye, 11 Mayıs 2022
Objective: Different lingual split patterns may occur during Bilateral Sagittal Split
Osteotomy(BSSO).One of the factors affecting the formation of different split patterns is the
osteotomy technique. The aim of this study is to determine the effect of inferior border and
medial horizontal osteotomy technique on lingual fracture patterns in BSSO.
Materials-Methods: Retrospective study was designed by the authors on the 126 patients(252
splits) who underwent BSSO acording to Hunsuck Modification. The predictor variable were
inferior border osteotomy type(lingual,caudal, buccal) and length medial horizontal bone
cut(anterior-posterior of lingula). The primary outcome was lingual split pattern. The predictor
variable and primary outcome were evaluated on 3-D reconstruction of CBCT. The outcomes
was the types of lingual split pattern on postoperative CBCT images were classified as according
to lingual split scale (LSS) of Plooij et al. Fisher Exact test were used to analysis categorical
data.
Results: A total of 256 lingual split patterns 134(%68) were LSS type 1,4(%2) were LSS type
2,56(%28) were LSS type 3 and 3(%1.5) were LSS type 4. There was no statistically significant
relationship between the length of the horizontal medial bone cut and the LSS(p=0.262).
Inferior border osteotomy extended to the lingual cortex LSS Type 1 was seen at the highest
rate. LSS Type 4 (unfavourable split pattern) was higest in buccal osteotomy group. There was
statistically significant relationship between inferior border cut type and LSS(p<0.001).
Conclusion: The results of this study showed that the inferior border osteotomy should extend
to the lingual cortex for avoiding unfavorable split pattern.