THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY

ABSTRACT Aim: Bilateral sagittal split ramus osteotomy (BSSRO) is commonly used to correct mandibular deformities. The first cut for this osteotomy is performed on the medial aspect above the lingula. During this procedure; The most feared intraoperative complication, the undesired fracture. Most of the BSSRO complications consist of condyle fracture or buccal/lingual plate fracture. The aim of this study was to determined the distance between the lingula and the sigmoid notch which is a surgical importance for BSSRO. Material and Methods: This retrospective study composed of the cone beam computed tomography images that were obtained at the our clinic. The sample compromised 70 patients (32 males and 38 females, with an age range of 12 to 28 years). The perpendicular distance between the fixed plane and upper limit of lingula was measured. The sample comprised 70 subjects (32 males and 38 females, with an age range of 12 to 28 years). The obtained data were statistically evaluated. Results: The minimum distance of the between fixed plane passing from sigmoid notch with lingula was found as a minimum of 4.80mm and a maximum of 19.20mm (mean±std. dev.= 11.99mm±2.40, n=140). The right and left side measurement ranged from 4.80mm to 16.4mm (mean±std. dev=11.34mm±2.26, n=70) and 7.72mm to 19.20mm (mean±std. dev.= 12.64mm±2.39, n=70), respectively. Conclusion: The findings obtained in this study provide a guideline for surgeons performing BSSRO on young populations in Turkey. Pre-procedural three-dimensional evaluation provides valuable information to prevent undesirable fractures. Keywords: Horizontal Ramus Osteotomy, CBCT, Sagittal Split Osteotomy SAGİTTAL SPLİT RAMUS OSTEOTOMİSİNDE RAMUS KESİSİ İÇİN GÜVENİLİR SINIRLARIN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ İLE BELİRLENMESİ: RETROSPEKTİF PİLOT ÇALIŞMA ÖZ Amaç: Bilateral sagittal split ramus osteotomisi, mandibular deformiteleri düzeltmek için sıklıkla kullanılan cerrahi bir yöntemdir. Bu osteotomi için ilk kesi lingula üzerinden geçen bir hat üzerinde gerçekleştirilir. Bu cerrahi sırasında en korkulan intraoperatif komplikasyon istenmeyen kırık oluşumudur. Operasyon esnasında hem proksimal hem de distal segmentlerde kırık oluşabilir. Bu çalışmanın amacı, güvenli bir bilateral sagittal split ramus osteotomisi için cerrahi önemi olan lingula ve sigmoid çentik arasındaki mesafeyi belirlemektir. Gereç ve Yöntem: Bu retrospektif çalışma, kliniğimizde çeşitli dental sebeplerle elde edilen konik ışınlı bilgisayarlı tomografi görüntüleri üzerinde gerçekleştirildi. Aksiyel düzlem, sigmoid çentikten geçecek şekilde konumlandırılarak, oluşturulan sabit düzlem ile lingula üst sınırı arasındaki dikey mesafe ölçüldü. Örneklem 70 kişinin (12-28 yaş aralığında, 32 erkek, 38 kadın) verilerini içermekteydi. Veriler istatistiksel olarak değerlendirildi. Bulgular: Minimum mesafe 4.8 mm maksimum mesafe 19 mm olarak bulundu (ort±std sapma=11,99 mm±2.40, n=140). Sağ ve sol taraf ölçümleri sırasıyla 4.80 mm’den16.4mm’ye (ort±std. sapma= 11.34mm± 2.26, n=70), 7.72mm’den 19.20mm’ye (std. dev.= 12.64mm±2.39, n=70) değişmekteydi. Sonuç: Bu çalışmada elde edilen bulgular genç Türk popülasyonuna bilateral sagittal split ramus osteotomisi için cerrahlara bir rehber olabilir. Prosedür öncesi üç boyutlu değerlendirme, istenmeyen fraktürlerin önlenmesinde değerli bilgiler sağlar. Anahtar Kelimeler: Horizontal Ramus Kesisi, KIBT, Sagittal Split Osteotomisi

Anahtar Kelimeler:

Horizontal Ramus Osteotomy, CBCT

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