Fixation Methods Used in Sagittal Split Ramus Osteotomy

Abstract

The sagittal split ramus osteotomy (SSRO) is a technique frequently used in orthognathic surgery for the treatment of congenital or acquired mandibular irregularities. Congenital or acquired deformities of the mandible, such as hypoplasia, hyperplasia, and asymmetry, can be corrected with this method. The SSRO procedure creates a broad bone contact surface in the mandible, supporting both post-operative stability and the early healing process. Additionally, this technique prepares a suitable foundation for the application of various fixation methods. The correct fixation of the segments after osteotomy directly affects the success of the procedure. Ensuring immobility between the bone fragments is of critical importance to the success of the surgery. Among the fixation materials and techniques used after SSRO are wire osteosynthesis, intermaxillary fixation, bicortical screw systems, mini plate-screw systems, hybrid systems using bicortical screws and plates, and resorbable mini plate-screw systems. An ideal fixation system should promote rapid bone healing, the commencement of early mandibular function post-operatively, and a reduction in the amount of relapse. However, despite many studies on this topic, an universally accepted ideal fixation method has yet to be determined. In our review, various fixation types and methods used for the frequently applied SSRO method in orthognathic surgery have been examined in detail. Information on the advantages, disadvantages, and effectiveness in clinical application of these techniques has been provided. The selection of the correct fixation method, which plays a critical role in the success of SSRO, is believed to directly impact both patient outcomes and the healing process. In this context, our review aims to provide clinicians with information and guidance in determining the most suitable fixation method for potential clinical scenarios they may encounter.

Keywords

• fixation
• stabilization
• sagittal split ramus osteotomy

References

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