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What Is a Sagittal Split Osteotomy?

A sagittal split osteotomy is a transformative surgical procedure that realigns the jaw for improved function and aesthetics. By carefully splitting the jawbone and repositioning it, this operation can correct bite irregularities and enhance facial harmony. Intrigued by how this intricate surgery can impact lives? Discover the step-by-step process and real patient transformations in our comprehensive visual guide. What could this mean for you?
Carol Kindle
Carol Kindle

A sagittal split osteotomy is an oral surgery procedure that is done to correct any serious misalignment of the upper and lower teeth. The bone on the sagittal — or side — of the lower mandible of the jaw is cut on each side to form a split. This allows the front part of the mandible to slide backward or forward until the teeth are aligned. The bones are then held in place with screws and allowed to heal. Patients with a severe overbite or underbite may benefit from the sagittal split osteotomy.

Misalignment of the upper and lower teeth can occur when the mandible is either too long or too short. Patients with this condition may experience difficulty chewing, or they may have pain in the joint. They may also have a receding chin line. Surgery of the jaw, also known as orthognathic surgery, may provide some relief while improving the appearance of the face. Specifically, the sagittal split osteotomy is done to align the upper and lower teeth.

People who undergo a sagittal split osteotomy need to practice good oral hygiene.
People who undergo a sagittal split osteotomy need to practice good oral hygiene.

The dentist, orthodontist, and the maxillofacial surgeon need to evaluate the patient carefully and plan the surgical approach. Patients must have previously had their wisdom teeth or third molars removed. The dentist may also have the patient wear braces for up to six months prior to surgery in order to straighten the teeth. Planning the surgery also involves having x-rays of the entire mouth.

A sagittal split osteotomy will be performed with the patient under general anesthesia.
A sagittal split osteotomy will be performed with the patient under general anesthesia.

A sagittal split osteotomy is performed by a maxillofacial surgeon while the patient is under general anesthesia. Braces applied prior to surgery usually remain on the teeth during the procedure. All surgical incisions are made through the mouth so there is no visible scarring on the face after the procedure. The surgeon will begin by making an incision to expose the bone on each side of the mouth behind the last molars. A surgical saw will be used to slice the bone of the mandible lengthwise from the back of the jaw to the area beneath the second molars.

Swelling in the jaw area may be present for a few weeks following a sagittal split osteotomy.
Swelling in the jaw area may be present for a few weeks following a sagittal split osteotomy.

The front of the mandible is separated from the rear portion that extends to the ear. Large flat areas of the mandible bone are still in contact, which aids in the healing. Once the bone is cut on both sides, the front of the jaw can either be made to slide forward or backward to get the teeth aligned. Metal screws are then placed in the mandible to reattach the bone and allow healing to occur. New bone should form over top of the screws, so they should not need to be removed.

Taking X-rays of the mouth will be performed prior to a sagittal split osteotomy.
Taking X-rays of the mouth will be performed prior to a sagittal split osteotomy.

A full recovery following a sagittal split osteotomy may take several months. During the first week after the procedure, patients may need to take pain medication and antibiotics. Swelling in the jaw area may also be present for a few weeks. A diet in soft foods, good oral hygiene, and ice packs for the swelling can aid in recovery.

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    • People who undergo a sagittal split osteotomy need to practice good oral hygiene.
      By: CandyBox Images
      People who undergo a sagittal split osteotomy need to practice good oral hygiene.
    • A sagittal split osteotomy will be performed with the patient under general anesthesia.
      By: Tyler Olson
      A sagittal split osteotomy will be performed with the patient under general anesthesia.
    • Swelling in the jaw area may be present for a few weeks following a sagittal split osteotomy.
      By: Yoanna Boyadzhieva
      Swelling in the jaw area may be present for a few weeks following a sagittal split osteotomy.
    • Taking X-rays of the mouth will be performed prior to a sagittal split osteotomy.
      By: Andrey Armyagov
      Taking X-rays of the mouth will be performed prior to a sagittal split osteotomy.
    • A sagittal split osteotomy is oral surgery that's meant to correct misaligned teeth.
      By: Valeriy Velikov
      A sagittal split osteotomy is oral surgery that's meant to correct misaligned teeth.
    • Antibiotics may be prescribed to prevent infection following a sagittal split osteotomy.
      By: andreeastock
      Antibiotics may be prescribed to prevent infection following a sagittal split osteotomy.
    • Misalignment of the upper and lower teeth can occur when the mandible is either too long or too short.
      By: snapgalleria
      Misalignment of the upper and lower teeth can occur when the mandible is either too long or too short.
    • A dentist may recommend that a patient wear braces for 6 months prior to having a sagittal split osteotomy.
      By: michaeljung
      A dentist may recommend that a patient wear braces for 6 months prior to having a sagittal split osteotomy.
    • Patients who have severe underbites may benefit from having a sagittal split osteotomy.
      By: ruigsantos
      Patients who have severe underbites may benefit from having a sagittal split osteotomy.