Mandibular sagittal split osteotomy for removal of impacted mandibular teeth: Indications, surgical pitfalls and final outcome

Publication date: Available online 4 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Paolo Scolozzi, Zulma Catherine
PurposeTo determine the indications for and to evaluate the surgical pitfalls and final outcomes of mandibular sagittal split osteotomy (MSSO) for the removal of impacted mandibular teeth.Patients and MethodsIn this retrospective case series study, radiological and clinical data of all patients who underwent MSSO for the removal of impacted mandibular teeth between 2008 and 2015 at the University Hospital of Geneva were reviewed. The primary outcome variables were (1) the indication for the removal of impacted mandibular teeth by MSSO, (2) complications and (3) surgical pitfalls. Other variables included, age and gender, teeth involved, indication for tooth removal, concomitant lesions such as cysts and/or tumors and radiological features.ResultsTwenty-one mandibular-impacted teeth in 18 consecutive patients were extracted (18 third molars, 2 second molars and 1 first molar) by using MSSO. In all patients, the indication for the MSSO approach included deeply impacted teeth associated with an intimate relationship between the IAN and the dental roots as shown on CBCT or CT scan images. Six patients (33.3%) developed a non-disabling hypoesthesia of the IAN. Three patients (16.6%) had major complications including two cases of infections (11.1%) and one case of bad split (5.5%).ConclusionThe present study showed that the MSSO approach is a valuable method for removing deeply impacted teeth in close proximity to to the mandibular canal. Local factors, such as bone remodeling, concomitant large lesions (cysts and/or tumors) and mandibular canal within the buccal cortex, represent pitfalls that might increase the risk of developing complications.



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