Oral and maxillofacial surgeryBilateral sagittal split osteotomy in cadaveric pig mandibles: evaluation of the lingual fracture line based on the use of splitters and separators

ObjectiveTo analyze the splitting pathways of the (lingual) fracture lines during a bilateral sagittal split osteotomy (BSSO) in cadaveric pig mandibles.Study designA BSSO was performed using splitters and separators. Special attention was paid to end the horizontal medial cut at the deepest point of the entrance of the mandibular foramen.ResultsOf all lingual fractures, 95% ended in the mandibular foramen. Forty percent of these fractures extended through the mandibular canal and 40% extended inferiorly along the mandibular canal.ConclusionAlmost all lingual fracture lines ended in the mandibular foramen, most likely due to the placement of the medial cut in the concavity of the mandibular foramen. The mandibular foramen and canal could function as the path of least resistance in which the splitting pattern is seen. We conclude that a consistent splitting pattern was achieved without increasing the incidence of possible sequelae.