Suassuna TM, dos Santos EGF, Filho SMCM, Costa MTA, Araújo FAC, Filho JRL. Unfavorable fractures during Sagittal Split Osteotomy. What are the Risk Factors? A Retrospective Tomographic Study. J Clin Exp Dent. 2025;17(5):e501-6.

doi:10.4317/jced.62726

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References

1. Bockmann R, Meyns J, Dik E, Kessler P. The modifications of the sagittal ramus split osteotomy: a literature review. Plast Reconstr Surg Glob Open. 2014;2:e271. https://doi.org/10.1097/GOX.0000000000000127 PMid:25587505 PMCid:PMC4292253

2. MacIntosh RB. Experience with the Sagittal Osteotomy of the Mandibular Ramus: A 13-Year Review. J Maxillofac Surg. 1981;8:151-165. https://doi.org/10.1016/S0301-0503(81)80036-7 PMid:6974211

3. Peleg O, Mahmoud R, Shuster A, et al. Orthognathic surgery complications: The 10-year experience of a single center. J Cranio-Maxillofac Surg. 2021. https://doi.org/10.1016/j.jcms.2021.04.006 PMid:33994296

4. Steenen SA, van Wijk AJ, Becking AG. Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors. Int J Oral Maxillofac Surg. 2016;45(8):971-9. https://doi.org/10.1016/j.ijom.2016.02.011 PMid:26980136

5. Fujii Y, Hatori A, Horiuchi M, Sugiyama-Tamura T, Hamada H, Sugisaki R, et al. Computed tomography evaluation of risk factors for an undesirable buccal split during sagittal split ramus osteotomy. PLoS One. 2023;18(3):e0279850. https://doi.org/10.1371/journal.pone.0279850 PMid:36862692 PMCid:PMC9980734

6. Steenen SA, Becking AG. Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns. Int J Oral Maxillofac Surg. 2016;45(7):887-97. https://doi.org/10.1016/j.ijom.2016.02.001 PMid:26936377

7. Beukes J, Reyneke JP, Becker PJ. Variations in the anatomical dimensions of the mandibular ramus and the presence of third molars: its effect on the sagittal split ramus osteotomy. Int J Oral Maxillofac Surg. 2013;42(3):303-7. https://doi.org/10.1016/j.ijom.2012.09.020 PMid:23103025

8. Wang T, Han JJ, Oh HK, Park HJ, Jung S, Park YJ, Kook MS. Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible. J Craniofac Surg. 2016;27(5):e500-4. https://doi.org/10.1097/SCS.0000000000002798 PMid:27391522

9. Jiang N, Wang M, Bi R, Wu G, Zhu S, Liu Y. Risk factors for bad splits during sagittal split ramus osteotomy: a retrospective study of 964 cases. Br J Oral Maxillofac Surg. 2021;59(6):678-682. https://doi.org/10.1016/j.bjoms.2020.08.107 PMid:33952406

10. Salzano G, Audino G, Friscia M, Vaira LA, Biglio A, Maglitto F, Committeri U, Piombino P, Bonavolontà P, Petrocelli M, Perrotta S, Califano L. Bad splits in bilateral sagittal split osteotomy: A retrospective comparative analysis of the use of different tools. J Craniomaxillofac Surg. 2022;50(7):543-549. https://doi.org/10.1016/j.jcms.2022.06.009 PMid:35810073

11. Chandegra RK, Tsakalidis M, Pandya R, Stockton P. The Unfavourable Split: a novel classification and an 11-year retrospective study looking at alternative methods for management of this well-known complication. Br J Oral Maxillofac Surg. 2023;61(1):66-71. https://doi.org/10.1016/j.bjoms.2022.11.007 PMid:36566102

12. Telha W, Abotaleb B, Zhang J, Bi R, Zhu S, Jiang N. Correlation between mandibular anatomy and bad split occurrence during bilateral sagittal split osteotomy: a three-dimensional study. Clin Oral Investig. 2023;27(3):1035-1042. https://doi.org/10.1007/s00784-022-04665-w PMid:35953564

13. Verweij JP, Mensink G, Fiocco M, van Merkesteyn JPR. Presence of mandibular third molars during bilateral sagittal split osteotomy increases the possibility of bad split but not the risk of other post-operative complications. J Cranio-Maxillofac Surg. 2014;42(7):e359-e63. https://doi.org/10.1016/j.jcms.2014.03.019 PMid:24787081

14. Eshghpour M, Labafchi A, Samieirad S, Hosseini Abrishami M, Nodehi E, Rashid Javan A. Does the Presence of Impacted Mandibular Third Molars Increase the Risk of Bad Split Incidence During Bilateral Sagittal Split Osteotomy? World J Plast Surg. 2021;10(1):37-42. https://doi.org/10.29252/wjps.10.1.37 PMid:33833952 PMCid:PMC8016376

15. Chi H, Cai M. A retrospective study of unfavorable fractures during sagittal split osteotomy: A single surgeon's experience. Chin J Plast Reconstr Surg. 2022;4:100-104. https://doi.org/10.1016/j.cjprs.2022.06.002

16. de Souza BB, da Silveira MLM, Dantas WRM, Almeida RAC, Germano AR. Does the presence of third molars during sagittal split mandibular ramus osteotomy favour complications? Systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2023;52(1):51-59. https://doi.org/10.1016/j.ijom.2022.07.001 PMid:35934567

17. Muto T, Shigeo K, Yamamoto K, Kawakami J. Computed tomography morphology of the mandibular ramus in prognathism: effect on the medial osteotomy of the sagittal split ramus osteotomy. J Oral Maxillofac Surg. 2003;61(1):89-93. https://doi.org/10.1053/joms.2003.50014 PMid:12524614

18. Aarabi M, Tabrizi R, Hekmat M, Shahidi S, Puzesh A. Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy. J Oral Maxillofac Surg. 2014;72(12):2508-13. https://doi.org/10.1016/j.joms.2014.05.008 PMid:25149670

19. Wang M, Li P, Zhang J, Sun Y, Zhang X, Jiang N. Risk Factors Analysis for Different Types of Unfavorable Fracture Patterns During Sagittal Split Ramus Osteotomy: A Retrospective Study of 2008 Sides. Aesthetic Plast Surg. 2022;46(5):2348-2355. https://doi.org/10.1007/s00266-021-02742-1 PMid:34984494

20. Falter B, Schepers S, Vrielinck L, Lambrichts I, Thijs H, Politis C. Occurrence of bad splits during sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(4):430-5. https://doi.org/10.1016/j.tripleo.2010.02.003 PMid:20452254

21. Gateno J, Ferraz F, Alfi D. Bad split: anatomic or technical problem? J Oral Maxillofac Surg. 2015;73(6):1023-4. https://doi.org/10.1016/j.joms.2015.01.040 PMid:25981833

22. Fujii Y, Hatori A, Horiuchi M, Sugiyama-Tamura T, Hamada H, Sugisaki R, Kanno Y, Sato M, Kono M, Hasegawa O, Kawase-Koga Y, Chikazu D. Computed tomography evaluation of risk factors for an undesirable buccal split during sagittal split ramus osteotomy. PLoS One. 2023;18(3):e0279850. https://doi.org/10.1371/journal.pone.0279850 PMid:36862692 PMCid:PMC9980734