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Bilateral Sagittal Split Osteotomy


Bilateral Sagittal Split Osteotomy, or BSSO, is a surgical procedure used for patients who need jaw repositioning. It has become very popular as it offers significantly better results with a lower risk profile than older, more traditional surgery methods. This article will explore what a bilateral sagittal split osteotomy is and how it benefits patients.

The first paragraph of this article will outline the basics of BSSO, so patients can understand exactly what the procedure entails. The second paragraph will provide a detailed description of how the procedure works and its advantages compared to other treatments, while also addressing potential risks that are considered by medical professionals before recommending it. Lastly, we will discuss some common questions about BSSO that might arise when considering this type of treatment option.

BSSO is one of the most common jaw correction procedures performed by oral and maxillofacial surgeons and it can make a huge difference for patients with large bite discrepancies. Therefore, understanding all aspects involved in the process is crucial if you are considering undergoing this type of procedure.

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Jaw Surgery Before and After Patient – Burke & Redford Orthodontists


Definition Of Bilateral Sagittal Split Osteotomy (BSSO)

When it comes to dealing with severe jaw size mismatch/position issues, BSSO can be a great option. This procedure, also known as a bilateral sagittal split osteotomy (BSSO), is used to correct malocclusion of the lower jaw. The goal of this process is to realign the mandible so that it fits properly with the maxilla and other facial structures.

The surgery itself involves cutting through both sides of the lower jawbone to allow for repositioning. Once the lower jaw is re-set, metal plates are used to hold the bone segments in their new positions until they eventually fuse back together. With proper healing time and follow-up care, patients who undergo BSS can experience long-term improvements in their bite alignment and overall facial appearance.

What is The Orthodontist’s Role in Orthognathic Surgery?

Bilateral sagittal split osteotomy is a surgical procedure used to correct the position of the lower jawbone. It is performed by an experienced maxillofacial (oral) surgeon specialist. The recovery time after BSS is typically 6-8 weeks and may vary depending on the complexity of the case and the patient’s individual biology.

bilateral sagittal split osteotomy
Bilateral Sagittal Split Osteotomy

The orthodontist plays a vital role in the successful outcome of bilateral sagittal split osteotomy. Dr. Ryan Redford and Dr. Michael Burke are responsible for preparing the patient’s teeth – getting them leveled and aligned – so that they fit together well once the jaw(s) are repositioned with surgery. This includes moving, rotating, or expanding teeth as needed to create upper and lower teeth arches that are well coordinated prior to the operation. Additionally, our doctors will provide support and guidance throughout treatment by making sure any necessary adjustments are made during recovery.

A major component of their job is monitoring progress post-surgery and addressing any issues that arise due to improper healing or misalignment. Once surgery is complete, braces are typically used to further ensure that all elements come together perfectly for a desirable result. In turn, this helps eliminate costly follow-up procedures or additional surgeries down the line. Orthodontists also play a huge part in helping patients feel more confident about their smile afterwards through personalized care plans tailored to everyone’s needs.

Conditions Bilateral Sagittal Split Osteotomy Treats

Bilateral sagittal split osteotomy is a surgical procedure used to treat several conditions affecting the jaw. It can be performed for medical, functional, and aesthetic purposes to improve both oral health and facial appearance. Yet it is not without its risks—any act of surgery carries with it a degree of uncertainty.

When done properly in conjunction with Burke & Redford Orthodontists, this type of procedure offers patients a wide variety of benefits that can improve their overall quality of life.

The main purpose behind performing bilateral sagittal split osteotomy is to correct severe misalignment or malocclusion of the jaws. This can occur because of genetic disorders like Marfan syndrome or Ehlers-Danlos Syndrome, autoimmune disorders such as rheumatoid arthritis, or simply genetically acquired jaw relationships.

The aim is to realign the lower and upper jaws, so they fit together properly. In addition to improving biting and che


wing function, many patients also experience improved confidence in their facial aesthetics after undergoing this type of surgery.

Who Needs a Bilateral Sagittal Split Osteotomy?

This type of surgery is usually recommended for people who have severe bite problems that cannot be corrected with orthodontics (tooth movement) alone.

Patients who need BSSO typically suffer from overbites – or, in other words, when the lower jaw sets behind the upper jaw excessively. The purpose of this procedure is to advance the lower jaw to align properly with the upper jaw – improving facial aesthetics as well as oral function. This is referred to as a BSSO advancement.

BSSO may also be beneficial for those with an underbite and who need movement of both the upper and lower jaws. Nowadays, surgeons prefer to advance the upper jaw to correct an underbite as setting the lower jaw back may negatively affect the airway. If the discrepancy is too large to correct by only moving the upper jaw, however, the lower jaw may need to be set back some. This is referred to as a BSSO setback.

Ultimately, an experienced orthodontist or maxillofacial surgeon can tell if someone needs BSSO based on their individual case history and clinical examination results.

mandibular surgery
Mandibular Surgery
Bilateral Sagittal Split Osteotomy Procedure

People often ask whether a bilateral sagittal split osteotomy (BSSO) is painful. The answer is that the procedure itself is not typically painful, as it involves general anesthesia. However, recovery can be difficult as swelling and pain can occur, which may require medication to manage. Time away from work or school will also be needed.

Let us look at what happens during BSSO surgery. During the procedure, an incision will be made in the gum line of your lower jaw to access the bone. Importantly, this incision is located inside of the mouth. There are no incision marks/scars that will be present outside of the mouth. This initial incision allows your surgeon to make precise cuts along either side of the mandible before separating the two sides from each other. Once separated, they can then move one or both halves into their desired position. Once positioned ideally, the two segments of bone are stabilized with plates. Finally, the area is closed with sutures. Recovery time varies by patient but usually takes several weeks until full movement and function are restored.

Estimated Recovery Time of a BSS

The recovery time after a bilateral sagittal split osteotomy (BSS) can vary depending on the individual patient. Generally, this procedure requires stabilization of the jaw with plates and screws to help ensure proper healing. Elastics that run from upper to lower braces will also be directed to assist healing in the proper bite relationship.

This will usually require at least four weeks of being off work or school as well as limiting certain activities such as strenuous exercise during that period. After this initial period of rest, patients may begin a course of physical therapy exercises which focus on stretching, strengthening, and restoring range of motion in the area operated upon.

It is important for patients to follow their doctor’s instructions closely when it comes to post-operative care so they can properly heal from their BSSO surgery. Patients should be aware that although there is a typical recovery timeline associated with this type of operation, each person’s experience could differ based on factors such as age, medical history, and overall health status prior to surgery.

Following these guidelines helps reduce risks associated with an incomplete recovery process; if any problems arise, contact your doctor right away.

Orthodontic Recommendation and Referral to Maxillofacial Surgery Specialist

Having discussed the estimated recovery time of a BSS, it is important to emphasize that orthodontic treatment (braces, typically) will be needed before, during, and after the procedure. The orthodontist and maxillofacial surgeon will work closely together as part of a team.

Our orthodontists can provide guidance on how to prepare for surgery, as well as ensuring proper “finishing” following healing. It will also be necessary to refer patients to a maxillofacial surgeon prior to starting the orthodontic process to ensure that a bilateral sagittal split osteotomy is needed and to consult regarding pros and cons as well as risks and benefits.

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When considering whether to proceed with a BSSO, it is essential that all other factors including physical condition and age are considered to ensure successful results. Ultimately, referral from an orthodontist or general dentist to an experienced maxillofacial surgeon will help determine if this type of surgery is right for each patient individually.

For those who suffer from misalignment of jaws or facial deformities that cannot be corrected with braces alone, Bilateral Sagittal Split Osteotomy might offer them a solution and improved quality of life. Learn how braces can help correct asymmetrical faces with orthodontics.

Call (951) 699-8011 during business hours to schedule a free orthodontic consultation with Dr. Ryan Redford or Dr. Burke so they can assess your situation and discuss options for bite correction.

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