bilateral sagittal split osteotomy

3 min read 18-03-2025

Meta Description: Learn about Bilateral Sagittal Split Osteotomy (BSSRO), a surgical procedure used to correct jaw misalignment. This comprehensive guide covers the procedure, recovery, risks, and more. Discover if BSSRO is the right treatment for you. (158 characters)

What is a Bilateral Sagittal Split Osteotomy (BSSRO)?

Bilateral Sagittal Split Osteotomy (BSSRO) is a surgical procedure used to correct severe jaw misalignment, also known as malocclusion. It's commonly performed to address underbites (mandibular prognathism) where the lower jaw significantly protrudes beyond the upper jaw. The procedure involves precisely cutting the lower jawbone (mandible) into two halves, allowing surgeons to reposition and realign it.

Why is BSSRO Performed?

BSSRO isn't a routine procedure. It's reserved for cases of significant jaw misalignment that significantly impact chewing, speaking, or facial aesthetics. Conditions often addressed with BSSRO include:

Severe underbite (mandibular prognathism): This is the most common reason for BSSRO. The lower jaw's forward positioning causes teeth to misalign, leading to difficulties with biting and chewing.
Facial asymmetry: While primarily used for jaw alignment, BSSRO can help correct some facial asymmetries.
Temporomandibular joint (TMJ) disorders: In some cases, correcting jaw misalignment can alleviate TMJ pain and dysfunction.
Sleep apnea: In severe cases, jaw misalignment can contribute to sleep apnea. BSSRO, in conjunction with other treatments, may improve breathing during sleep.

Who is a Candidate for BSSRO?

Determining candidacy for BSSRO requires a thorough evaluation by an oral and maxillofacial surgeon (OMS). Factors considered include:

Severity of jaw misalignment: The degree of malocclusion determines the need for surgery.
Overall health: Patients should be in good general health to undergo surgery.
Growth and development: BSSRO is usually performed after the patient's jaw growth has completed.
Expectations and goals: Realistic expectations are crucial for a successful outcome.

The BSSRO Procedure: A Step-by-Step Overview

BSSRO is typically performed under general anesthesia. The detailed steps may vary slightly depending on the surgeon's technique, but the general process involves:

Incison: A small incision is made inside the mouth, usually along the lower gum line, to minimize visible scarring.
Osteotomy: The mandible is carefully cut using specialized surgical instruments, creating two sagittal splits. This splitting allows for precise movement and repositioning of the jaw segments.
Repositioning: The lower jaw segments are then repositioned to correct the malocclusion. This is guided by pre-surgical planning and imaging.
Fixation: Small plates and screws are used to securely fix the repositioned jaw segments in their new positions. These generally remain in place permanently.
Closure: The incision is closed with sutures.

What to Expect After BSSRO

Recovery from BSSRO is a gradual process. Expect:

Swelling and bruising: This is normal and typically peaks within a few days after surgery.
Pain and discomfort: Pain medication is prescribed to manage post-operative pain.
Liquid diet: A liquid diet is initially necessary, gradually progressing to soft foods.
Jaw stiffness: Expect some stiffness and limited jaw opening for several weeks.
Regular follow-up appointments: Post-operative appointments are essential for monitoring healing and adjusting to the new jaw position.

Potential Risks and Complications of BSSRO

As with any surgical procedure, BSSRO carries potential risks and complications, including:

Infection: As with any surgery, infection is a possibility. Antibiotics are prescribed to minimize this risk.
Nerve damage: Damage to nerves in the jaw area can cause numbness or tingling in the lower lip and chin. This is usually temporary but can sometimes be permanent.
Bleeding: Excessive bleeding is uncommon but can occur.
Non-union: In rare cases, the jaw segments may not heal properly.
Malunion: The jaw segments may heal in an incorrect position.

Is BSSRO Right for You?

Determining if BSSRO is the appropriate treatment requires a consultation with an experienced oral and maxillofacial surgeon. They will conduct a thorough examination, assess your specific needs, and discuss the risks and benefits of the procedure.

Remember, this information is for educational purposes only and shouldn't be considered medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.