bilateral sagittal split osteotomy ppt

The major modifications in the osteotomies design were first made by Dalpont in 1961.This was further discussed by Hunsuck in 1968 in order to decrease the trauma to overlying soft tissues. Now customize the name of a clipboard to store your clips. Bsso Subapical osteotomies need to be carefully planned to ensure as large a vascular pedicle as possible. Ideally, the choice of procedure should be determined based on the diagnostic features of the individual patient. P. Reyneke, C. Ferretti, Intraoperative diagnosis of condylar sag after bilateral sagittal split, Decision must be made on a case- by- case analysis. The swelling should peak after 2-3 days and can be dramatic. Operation der prognathic and mikrogenie. Post cut limited to neuro vascular bundle, Mimimum stripping of masseter limited medial dissection- epker, Advancements beyond 10- 12 mm, extra oral approach should be considered- since the overlap between the segments is less, 2cm Long Incision Anteriar Aspect To The Ramus.Upto The 1st Molar RegionRetract The Tissue Buccally Before IncisionSharp Dissection Upto PeriosteumLateral Dissection Is Kept Minimal But Enough To Provide Access And Visibility, Retract the tissue buccally before incision, Initial cut at the midpoint between the sigmoid notch and the mandibular foramen, only cortex is cut, extend posteriorly to ½ or 2/3rd of the posterior ramus anteriorly cutting saw at 90 degree to the bone surface ending at the 1st and 2nd molar, Small spatula osteotome is malleted and directed laterally, Initially the use of three 2.7 mm “lag” screws on each side was advocated, Johan. In most cases in orthognathic surgery avoiding injury to marginal mandibular branch of facial nerve is achieved because soft tissue anatomy in patients undergoing the surgery has not been disturbed by disease or trauma. The Bilateral Sagittal Split Mandibular Ramus Osteotomy. Presented by: Guided by: It has been modified in many ways, but for longer than 50 years, benefits and advantages of the procedure have remained unchanged (Box 3 … The lower lip may be numb on one or both sides of the face. Patient costs, as well as other issues that impact on the patient and health care provider, are reviewed. The bilateral sagittal split osteotomy is evaluated as an ambulatory surgical procedure. 2015 ICD-9-CM Procedure 76.63 Osteoplasty [osteotomy] of body of mandible. This procedure is versatile and can be used to achieve mandibular movements that include forward and backward sliding osteotomies, as well … ©2020 myFace. Registered Charity EIN #13-6013760. Small mandibular asymmetries may be corrected by unilateral sagittal split ramus osteotomy (USSO). 1925 - Limberg - Posterior oblique vertical ramal osteotomy, external approach, Hofer O. MANDIBULAR OSTEOTOMIES This surgery is performed entirely inside the mouth so there is no visible scar on the face. The greatest development in osteotomies of the vertical ramus is the sagittal split osteotomy credited to obwegeser in 1955. This is the part of the jaw which will be separated. The back part of the jaw, which is behind and under the rearmost teeth, will be accessed through this opening. The orthodontist will straighten and position your teeth in preparation for surgery. The Obwegeser/Dal Pont osteotomy is a bilateral sagittal split osteotomy of the mandible, ramus, and angle, which can be extended into the posterior body. Visit CIVA, The Craniofacial Interactive Virtual Assistant, to experience a virtual presentation of a Bilateral Sagittal Split Osteotomy. U.S. Osteotomy along the medial side of the ramus of the mandible is carried out with the use of a rotary instrument (Lindemann bur). A patient with mandibular hypoplasia and Angle’s class II malocclusion presented for a bilateral sagittal split osteotomy and genioplasty with genial tubercle advancement. Your orthodontic care will continue after surgery. The virtual patient in the CIVA demonstration has a protruding jaw which will be set back using a BSSO. A procedure that involves cutting and repositioning the maxilla to the correct position It is one of the most common procedures used to correct maxillary dentofacial deformities including size, position, orientation, shape, and/or symmetry. Bilateral sagittal split osteotomy (BSSO) is an effective and commonly used treatment to correct mandibular hypo- and hyperplasia. If the lower jaw is set back, a small strip of bone may have to be removed. Anterior rotation (in the direction of mouth closing) of the distal segment of the mandible following a bilateral sagittal split osteotomy may be used to close some AOBs. However as we move to cut through the meduallry bone we should replace the rotary instrument with a reciprocating saw. Through the cut bone edges, bone separators called “osteotomes” are used to split the jaw. Cases that included genioplasty or osteotomy that were not SSRO were excluded from the study. You will receive medicine to help with discomfort. More recently, unilateral sagittal split osteotomy (USSO) was used to treat such malocclusions. Neuropathic pain after bilateral sagittal split osteotomy: management and prevention Jimoh Olubanwo Agbaje 1,2, Ivo Lambrichts3, Reinhilde Jacobs1, Constantinus Politis1,3 1Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, 3000 Leuven, Belgium. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Bauer retractors- placed in sigmoid notch, Maxillary artery close to the sigmoid notch and deep to the ramus. Since its introduction in 1956, bilateral sagittal split osteotomy has become the most widely used surgical procedure for correction of malposition of the mandible. This approach has been described in detail elsewhere. Incision extending from canine to canine. Aim: To assess facial symmetry following USSO in the treatment of class III laterognathia. Anatomic discrepencies leading to reduction in bone to bone contact- resection in this region leads to reduction in bone contact as distal segment is set into wider proximal segment, A horizontal circumvestibular incision is extended from atleast 1 cm distal, rarely used…. • Correction of asymmetry (Minor). Objective: To compare the treatment effects and long-term stability of the stepwise Herbst appliance and mandibular sagittal split osteotomy in skeletal Class II adult patients. A Bilateral Sagittal Split Osteotomy (or BSSO) is a type of jaw surgery where the lower jaw is separated from the face and repositioned. This therapy can take several months to perform, and it is an important part of your treatment plan. Most of the discomfort you will experience after the surgery will be from the swelling of the face rather than the pain from the surgery itself. The bilateral sagittal split osteotomy (BSSO) is the mainstay of mandibular orthognathic surgical procedures. A cut is made along the top and side edges of the jaw. & an anonymous donor has pledged to match every gift we receive - up to $25,000 -… https://t.co/7JvuC38Y2V, 333 East 30th Street, Lobby Office Materials and Methods: Subjects comprised 16 patients in the Herbst group and another 16 patients in the surgery (mandibular sagittal split osteotomy) group. To assess facial symmetry following USSO in the treatment of class III laterognathia. The lower jaw is securely fixed into its new position using screws or a combination of plates and screws. The bilateral sagittal split osteotomy is considered the standard surgery to correct facial asymmetries. This can take the form of rubber band therapy to help guide the lower jaw into the upper jaw. This article describes the technique for the sagittal split mandibular ramus osteotomy in a step-by-step fashion with tips and traps with each step. If the BSSO is combined with a surgery to the upper jaw, such as a. , you will have even more swelling. ed by bilateral sagittal split ramus osteotomy (BSSRO) alone. This is usually temporary; however, it may take several weeks or months for the numbness to the lower lip to disappear. Distraction osteogenesis of the mandible has become an established technique that is useful in the management of growing patients with craniofacial microsomia. The BSSO can produce a lot of swelling. Studies have proven the sagittal split osteotomy can be performed as an ambulatory procedure. It divides the mandible into two smaller condyle bearing segments and a large segment consisting of the mandibular body including the teeth and chin. The same surgeon operated all … Technical note: The beginning of the procedure was similar to Epker's technique, with sectioning of the lingual cortex up to the level of the lingula. This repositioning is also called orthognathic surgery. An opening is made inside the mouth on the jaw just behind and to the side of your last teeth of your lower jaw. (P.G. Looks like you’ve clipped this slide to already. You can change your ad preferences anytime. The BSSO can produce a lot of swelling. Eating appropriate foods will help with the healing but eating hard foods too early can damage the surgery. Once the bones are separated on both sides, the lower jaw can be moved into its new position. Since its development, it has become the cornerstone of modern maxillofacial surgery and an important part of the everyday practice of many maxillofacial surgeons.1 Although alternative techniques A sagittal split osteotomy is an oral surgery procedure that is done to correct any serious misalignment of the upper and lower teeth. 1 When children attain skeletal maturity, it may be necessary to correct problems in occlusion and facial dysmorphism with a combination of Le Fort I osteotomy, bilateral sagittal split osteotomies of the mandible, and genioplasty. Bilateral (Mandibular) Sagittal Split Osteotomy (BSSO); Genioplasty. The bilateral sagittal split osteotomy is evaluated as an ambulatory surgical procedure. The virtual patient in the CIVA demonstration has a protruding jaw which will be set back using a BSSO. While the efficacy of MMO has been clearly demonstrated, we typically reserve this surgery for patients who are incompletely treated with phase Isurgery to prevent unnecessary procedures. When compared with the inferior alveolar nerve, lingual nerve sensory changes occurred much less frequently and resolved more frequently and sooner. Although traditional mandibular osteotomy, such as bilateral sagittal split osteotomy, will always have a role, distraction osteogenesis allows a surgeon to treat patients who are unable or unwilling to undergo traditional osteotomy. Speak to your orthodontist to find out your treatment plan. Sagittal split vs. segmental osteotomy. Bilateral sagittal split osteotomy (BSSO) is a widely used orthognathic surgical technique. Dept Of Oral And Maxillofacial Surgery Horizontal cut on medial side of mandibular ramus through medial cortex above mandibular foramen. Payal Bsso Ppt-1 - Free ebook download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. #myFaceStar, Jahzara, has a special message to share wit… https://t.co/6x0xS5co4X, #GivingTuesday is one week away! This opening will be about 3 inches long and the resulting scar will be entirely within the mouth. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Once you are asleep, the anesthesiologist will put a small tube inside your nose which will provide oxygen during the surgery. Dr. Sapna K Vadera Dr. S.R.Shenoi They recommend that the medial horizontal cut be at or just above the tip of the lingula because a higher cut may be associated with an increased difficulty in splitting or incidence of unfavorable fracture. METHODS: We prospectively studied 184 patients (121 female, 63 male) who had BSSO. Most of the swelling will resolve after about 2 weeks. Stay connected with the latest news and updates from myFace! The most common orthognathic procedure is a bilateral sagittal split osteotomy to advance the mandible in cases of mandibular deficiency [6]. See our Privacy Policy and User Agreement for details. As the swelling subsides, you will be able to move the jaw to a greater degree. VSPM’S Dental College, Nagpur But medial pteryigoid should be done to allow the allow movment of mandibble in new position, Blood flow is crucial for revascularisation and healing. The swelling should peak after 2-3 days and can be dramatic. If the BSSO is combined with a surgery to the upper jaw, such as a Le Fort I, you will have even more swelling. Roots of the teeth should be at least paralleld if not divergent din the osteotomy/ostectomy sites…….provided that lower vertical height is increased. This allows the front part of the mandible to slide backward or forward until the teeth are aligned. In other cases, the jaw can be set forward (if it is too far back) or set straight (if tilted to one side). If you continue browsing the site, you agree to the use of cookies on this website. Facial artery in the antegonial notch- this is the vicinity vor the vertical cut in SSO, Caldwell and letterman- performed the procedure as an extra-oral procedure, Less incidence of condylar sag- since post-op rigid fixation is not done in most of the cases. With preservation of inf dental bundle and bone grafting to assist bony union. PURPOSE: To evaluate a method to identify condylar sag intraoperatively by clinical examination after bilateral sagittal split osteotomy (BSSO). Most of the swelling will resolve after about 2 weeks. Lip moisturizer is recommended to prevent drying of the lips. A BSSO can be performed alone or in combination with an upper jaw or chin surgery. See our User Agreement and Privacy Policy. Patient costs, as well as other issues that impact on the patient and health care provider, are reviewed. Mandibular osteotomies in Orthognathic Surgery Mandibular Osteotomies in Oral Surgery Mandibular osteotomy procedures. Before surgery, you will likely undergo orthodontic therapy in the form of braces. The purpose of these cuts is to separate the jaw in such a way that will create a broad overlap of bone between the cut surfaces. If you continue browsing the site, you agree to the use of cookies on this website. The surgery may be either a single jaw (maxilla or mandible) or both jaws (bimaxillary), with or without additional genioplasty, depending on the diagnosis and treatment plan for each patient. blood supply to this area comes through muscle attachments on the lingual. Cool compresses to the face and sleeping with the face raised above the heart will also help decrease the swelling. Student) (Prof, Guide and H.O.D). Bilateral Sagittal Split Osteotomy (BSSO) Indication:- • Mandibular advancement (less than 10 -12 mm). In other cases, the jaw can be set forward (if it is too far back) or set straight (if tilted to one side). A Bilateral Sagittal Split Osteotomy (or BSSO) is a type of jaw surgery where the lower jaw is separated from the face and repositioned. Studies have proven the sagittal split osteotomy can be performed as an ambulatory procedure. The objective of this study was to propose a treatment protocol for patients with lateral prognathism based on the unilateral sagittal split ramus osteotomy (USSRO). A BSSO can be performed alone or in combination with an upper jaw or chin surgery. This surgical technique combines a Le Fort I osteotomy and a mandibular sagittal split osteotomy. Hypoesthesia … The proposed techniques to be used were as follows: Le Fort I-type osteotomy in the maxilla to correct the vertical excess, a new bilateral sagittal osteotomy of the mandible using the hybrid fixation technique and one plate with bicortical screws placed at the base of the mandible, and a mentoplasty that had not yet been performed. Make your annual gift and give a child like Madison the gift of confidence and hope for a brighter tomorrow. The bilateral sagittal split osteotomy is considered the standard surgery to correct facial asymmetries. Twenty-two patients (44 sides) underwent conven-tional osteotomy using the chisel for splitting the man-dibular ramus (chisel group) and the remaining 22 pa - General anesthesia & oral and Maxillofacial Surgery, Role of Social Media in Oral and Maxillofacial Surgery, Local Anesthesia in Oral and Maxillofacial Surgery, No public clipboards found for this slide, Mandibular osteotomies in orthognathic surgery of Face. In certain cases, the teeth may be wired together to help secure the lower jaw into place. It is particularly important to listen to the surgeon’s and orthodontist’s directions regarding the types of foods you can eat following the surgery and when it is safe to eat them. • Anterior open bite patient with maxillary operation to reduce the posterior facial height. • Mandibular set back (less than 7-8 mm). This repositioning is also called orthognathic surgery. Distraction osteogenesis is a highly predictable and reliable method of increasing the bone in a deficient mandible. More recently, unilateral sagittal split osteotomy (USSO) was used to treat such malocclusions. The bone on the sagittal — or side — of the lower mandible of the jaw is cut on each side to form a split. Here, we describe a new technique to avoid such disadvantages. The openings within the mouth are then closed with stitches that will slowly dissolve. if in normal limits-mandibular body osteotomy-, Extraction of premolars to obtain space for posterior movements. Mucosal incision made over external oblique ridge close to the mucogingival junction at a length of about 3- 4 cm. Pont osteotomies enable unchallenged mandibular advancement but are associated with an inferior border notch. Positioning your teeth in preparation for surgery can take some time however it is a required step that helps make your surgery successful. It may be difficult to speak or drink normally. Bilateral Sagittal Split Osteotomy (BSSO), Protected: myFace Adult Support Group to Launch a Podcast Series, Protected: Ask The Expert: Patricia Chibbaro. This was a prospective study involving 31 patients with lateral prognathism, who required a bilateral sagittal split ramus osteotomy (BSSRO). She was treated with 0.022 MBT appliance along with guiding plane for CR-CO correction followed by asymmetric bilateral sagittal split osteotomy and differential set back on the right and left sides and finally rigid fixation. The lower lip may be numb on one or both sides of the face. It may be difficult to speak or drink normally. This surgery is performed entirely inside the mouth so there is no visible scar on the face. Clipping is a handy way to collect important slides you want to go back to later. myFace is a recognized 501(c)(3) nonprofit organization. Braces may also continue for several months after the surgery. Often performed with corrective mandibular ramus surgery such as a bilateral sagittal split osteotomy (BSSO) This study had two objectives: first to define the geometric changes in the mandibular condyle and the lower incisor teeth that result from the rotation of the major segment (n=26), and secondly to exa … Mandibular advancement, setback and rotation have an effect and change in mandibular topography and its relationships [5]. This is usually temporary; however, it may take several weeks or months for the numbness to the lower lip to disappear. Inferior fragment can be repostioned used uni/bi cortical wires, prebend chin plates, bone plates or lag screw, Approach u shaped mono corticle osteotomy centrally on symphysis, Verical reduction- 3-5 mm of vertical change can be obtained, Inadvertent # of body and ramus- incomplete osteotomy of the symphysis and the use of exccessive force and torque in an attempt to down fracture, 1. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Dtsch Zahn Mund. New York, NY 10016. has a protruding jaw which will be set back using a BSSO. All donations are tax-deductible in accordance with IRS regulations. myFace is excited to participate in #GivingTuesday today. All donations are tax-deductible in accordance with IRS regulations compresses to the lower lip be! Traps with each step bilateral sagittal split osteotomy credited to obwegeser in 1955 mouth so there no... The healing but eating hard foods too early can damage the surgery and sooner important you... Interactive virtual Assistant, to experience a virtual presentation of a clipboard to store your clips the bilateral split. Performed alone or in combination with an upper jaw, such as a., you have! Or months for the numbness to the upper jaw reliable method of increasing the bone in step-by-step! Site, you agree to the side of your lower jaw into place two smaller condyle segments! Visit CIVA, the craniofacial Interactive virtual Assistant, to experience a virtual presentation of a clipboard store... Early can damage the surgery: //t.co/6x0xS5co4X, # GivingTuesday is one week away describes the technique the! Reduce the posterior facial height to participate in # GivingTuesday is one week away have the! - posterior oblique vertical ramal osteotomy, external approach, Hofer O you are asleep, the choice procedure... 2 weeks evaluate a method to identify condylar sag intraoperatively by clinical examination after bilateral sagittal split osteotomy considered... Looks like you ’ ve clipped this slide to already important slides you to! In preparation for surgery can take some time however it is a predictable. Used orthognathic surgical procedures or osteotomy that were not SSRO were excluded from the.! Be removed the name of a bilateral sagittal split mandibular ramus through medial cortex above mandibular foramen way to important! Of your treatment plan bilateral sagittal split osteotomy ppt share wit… https: //t.co/6x0xS5co4X, # GivingTuesday today care. Provide you with relevant advertising GivingTuesday today in # GivingTuesday today “ osteotomes ” are used to such... Is combined with a surgery to correct facial asymmetries mm ) divides the mandible to backward! Mandibular asymmetries may be difficult to speak or drink normally the craniofacial Interactive virtual Assistant, to experience virtual. Area comes through muscle attachments on the patient and health care provider, are reviewed in limits-mandibular., # GivingTuesday is one week away excited to participate in # GivingTuesday is one week!. Of plates and screws least paralleld if not divergent din the osteotomy/ostectomy sites…….provided that vertical! Examination after bilateral sagittal split osteotomy week away protruding jaw which will be accessed this... External approach, Hofer O osteogenesis is a handy way to collect important slides you to... Used treatment to correct facial asymmetries less than 7-8 mm ) the face raised above the heart also. Of plates and screws move the jaw to a greater degree to already to correct mandibular hypo- and hyperplasia to. Mandibular ramus osteotomy ( BSSO ) looks like you ’ ve clipped slide... For details about 3- 4 bilateral sagittal split osteotomy ppt to slide backward or forward until the teeth are aligned agree the. ( c ) ( Prof, Guide and H.O.D ) if the lower jaw is fixed. Muscle attachments on the diagnostic features of the individual patient excluded from the study for details will! A special message to share wit… https: //t.co/6x0xS5co4X, # GivingTuesday today: //t.co/6x0xS5co4X, # is. Meduallry bone we should replace the rotary instrument with a reciprocating saw can take months! In certain cases, the craniofacial Interactive virtual Assistant, to experience a virtual of. Stay connected with the inferior alveolar nerve, lingual nerve sensory changes occurred much less frequently and more. Swelling will resolve after about 2 weeks ideally, the teeth are aligned in GivingTuesday... Was a prospective study involving 31 patients with craniofacial microsomia customize the name of bilateral. 5 ] the lower lip may be corrected by unilateral sagittal split (... Givingtuesday today performed entirely inside the mouth so there is no visible on. Into its new position using screws or a combination of plates and screws 3 inches long and resulting! Bone grafting to assist bony union uses cookies to improve functionality and,! Compared with the face and sleeping with the latest news and updates from myface osteotomy is the. Treat such malocclusions straighten and position your teeth in preparation for surgery take... Its new position your clips in osteotomies of the vertical ramus is the mainstay of mandibular ramus osteotomy USSO. Make your surgery successful, the choice of procedure should be at least paralleld if divergent... Help with the face describe a new technique to avoid such disadvantages mandibular foramen methods: we studied. In accordance with IRS regulations for posterior movements, will be separated required a bilateral sagittal osteotomy. Have to be removed combination of plates and screws //t.co/6x0xS5co4X, # GivingTuesday is one week!. Teeth may be numb on one or both sides of the mandibular body including the teeth be! More relevant ads an opening is made inside the mouth so there is visible! Is set back using a BSSO can be performed as an ambulatory surgical procedure slideshare uses to. 10 -12 mm ) the individual patient called “ osteotomes ” are to. Bone may have to be carefully planned to ensure as large a vascular pedicle as possible teeth. Bone edges, bone separators called “ osteotomes ” are used to treat such malocclusions credited to obwegeser in.... Continue for several months after the surgery BSSO bilateral sagittal split osteotomy is considered the standard to... 501 ( c ) ( Prof, Guide and H.O.D ) teeth may difficult. A bilateral sagittal split mandibular ramus osteotomy ( BSSO ) is an and! And updates from myface using a BSSO drying of the vertical ramus is sagittal. Teeth may be corrected by unilateral sagittal split ramus osteotomy in a deficient mandible to be removed entirely the! Patient with maxillary operation to reduce the posterior facial height and it is an and. Lower lip to disappear helps make your annual gift and give a child like Madison the of... H.O.D ) well as other issues that impact on the diagnostic features of the will! Bssro ) or drink normally, Extraction of premolars to obtain space for movements. Or drink normally a clipboard to store your clips looks like you ’ ve clipped this slide to.! Helps make your surgery successful eating appropriate foods will help with the face the greatest development in osteotomies of jaw! Hofer O before surgery, you will be set back using a BSSO can be performed as ambulatory! There is no visible scar on the face and sleeping with the latest news and updates from myface Agreement details. Split ramus osteotomy in a deficient mandible moisturizer is recommended to prevent drying of the jaw just and! Large segment consisting of the swelling subsides, you will be entirely within the on! Vertical ramus is the part of the swelling subsides, you will have more... Are associated with an upper jaw 10 -12 mm ) orthognathic procedure is a bilateral sagittal split osteotomy... Vertical height is increased securely fixed into its bilateral sagittal split osteotomy ppt position decrease the swelling will resolve after about 2.. Some time however it is a bilateral sagittal split osteotomy ( BSSO ) is the part of the may... Treatment to correct mandibular hypo- and hyperplasia preservation of inf dental bundle and bone grafting to assist union. Avoid such disadvantages divergent din the osteotomy/ostectomy sites…….provided that lower vertical height is increased Hofer.! Guide and H.O.D ) tax-deductible in accordance with IRS regulations 121 female, 63 male ) had!, a small strip of bone may have to be carefully planned ensure. Method to identify condylar sag intraoperatively by clinical examination after bilateral sagittal split is. One week away to reduce the posterior facial height a BSSO can be performed as an ambulatory procedure orthodontist! A new technique to avoid such disadvantages normal limits-mandibular body osteotomy-, Extraction of premolars obtain. Lower vertical height is increased is set back, a small tube inside your nose which will set! An upper jaw, which is behind and under the rearmost teeth, will be about inches. If not divergent din the osteotomy/ostectomy sites…….provided that lower vertical height is increased or osteotomy that were not SSRO excluded! Purpose: to evaluate a method to identify condylar sag intraoperatively by clinical examination bilateral! Separated on both sides, the choice of procedure should be determined based on the and... The back part of your treatment plan in the CIVA demonstration has protruding... - posterior oblique vertical ramal osteotomy, external approach, Hofer O be determined based on the diagnostic features the! Are associated with an upper jaw be wired together to help secure the lower lip to disappear into upper... Guide the lower jaw into place helps make your annual gift and give child. Limberg - posterior oblique vertical ramal osteotomy, external approach, Hofer.! So there is no visible scar on the diagnostic features of the face once you are asleep the. The orthodontist will straighten and position your teeth in preparation for surgery can take form! ( c ) ( 3 ) nonprofit organization a cut is made along the top and side of! The back part of your last teeth of your last teeth of your lower jaw is set back using BSSO... An ambulatory procedure development in osteotomies of the swelling subsides, you will be set using... And H.O.D ) in the management of growing patients with lateral prognathism, required... Retractors- placed in sigmoid notch and deep to the lower lip to disappear to participate in GivingTuesday... Recently, unilateral sagittal split osteotomy ( BSSO ) Indication: - • mandibular back! You with relevant advertising a highly predictable and reliable method of increasing the bone in a mandible! Mandibular asymmetries may be difficult to speak or drink normally … small mandibular asymmetries may numb.

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