“Triangular ostectomy”: effective removal of bony interference during orthognathic surgery for better postoperative bone regeneration

Introduction Sagittal split ramus osteotomy (SSRO) is commonly used to in orthognathic surgery especially in the treatment of mandible laterognathism. But frequently, distal and proximal mandible segments can't be aligned passively to another, which will impair bone regeneration after surgery. Herein, we developed a novel ostectomy method, named as “triangular ostectomy”, to remove bony interference fast and accurately, with the help of preoperative virtual planning and simulation. Methods A total of 12 patients were involved. The progress of orthognathic was simulated before surgery. “Triangle ostectomy”, “posterior bending osteotomy” (PBO) technique and grinding method were applied. The patients' CT images were achieved 3 days and 4 months after surgery and the evaluation of alignment of proximal and distal segments was then carried out. Results and Discussion After comparison, the “triangular ostectomy” was proved reliable to eliminate the bony interference quickly and accurately. The increased bone contact can accelerate postoperative bone regeneration. Furthermore, several tips during operation were also stated in this text to make this ostectomy easier and safer to operate. Conclusion This “triangular ostectomy” technique to remove mandible bony interference should be taken into consideration to achieve better bone regeneration after SSRO, especially treating patient with severe facial asymmetry.