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The International Journal of Adult Orthodontics & Orthogathic Surgery
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International Journal of Adult Orthodontics and Orthognathic Surgery

Year 1999
Volume 14 , Issue 4

Pages: 315 - 318

Modified sagittal split ramus osteotomy with a reciprocating saw and new retractors

Masahiro Furutani, DDS, PhD/Mineo Kawai, DDS, PhD/Toshihiko Takenobu, DDS/Futoshi Iwaki, DDS

Modified sagittal split ramus osteotomy with new instruments and a reciprocating saw is reported. With this modification, the sagittal separation of the ramus is performed by the reciprocating saw with an original wide-blade buccal retractor and a new lingual retractor, instead of the traditional channeled retractor. The wide-blade retractor is inserted to the buccal aspect of the mandibular ramus, which ensures protection from instrumental injury to the adjacent soft tissues and vessels, and the new lingual retractor, instead of the channeled retractor, is inserted to the lingual aspect of the ramus. The osteotomy line follows that of Dal Pontís modification. Close attention must be paid to the direction of the saw blade. The separated bone plane should be located in the external cortical bone layer of the ramus, so as to avoid injury of the inferior alveolar neurovascular bundle. The osteotomy is completed with the smooth osteotomized interface, which facilitates positioning of the bone segments by the surgeon. The new instruments and the reciprocating saw may provide safe and rapid sagittal split ramus osteotomy.


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