Patient-specific 3D-printed cutting guides for high oblique sagittal osteotomy-an innovative surgical technique for nerve preservation in orthognathic surgery

Peer W Kämmerer; Daniel Müller; Friedemann Linz; Priscila Ferrari Peron; Andreas Pabst

doi:10.1093/jscr/rjab345

Patient-specific 3D-printed cutting guides for high oblique sagittal osteotomy-an innovative surgical technique for nerve preservation in orthognathic surgery

J Surg Case Rep. 2021 Aug 26;2021(8):rjab345. doi: 10.1093/jscr/rjab345. eCollection 2021 Aug.

Authors

Peer W Kämmerer¹, Daniel Müller¹, Friedemann Linz¹, Priscila Ferrari Peron², Andreas Pabst¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany.
² Department of Orthodontics, University Medical Center Mainz, Mainz, Germany.

Abstract

Bilateral sagittal split osteotomy (BSSO) of the mandible according to Obwegeser/Dal Pont is considered to be gold standard in orthognathic surgery. Frequently reported complications of BSSO are injuries of the mandibular nerve resulting in paresthesia/anesthesia as well as inadequate mandibular bone fracturing ('bad split'). High oblique sagittal osteotomy (HOSO) was introduced to overcome these complications. We present an innovative HOSO modification using patient-specific 3D-printed cutting guides positioned on the outside of the ascending mandibular ramus and fixed in the incisura semilunaris, precisely marking the optimal height and angle of the osteotomy. Advantages are a decreased operation time due to the simplicity of this less invasive procedure, a potentially reduced frequency of mandibular nerve damage and bad splits as well as a lower bleeding risk.