Experience with mandibular sagital osteotomy proposed by Puricelli

Introduction: Bilateral sagital split ramus osteotomy is the most frequent technique indicated for mandibular morphological correction in orthognatic surgery, fixed by different osteosynthesis methods. Proposed by Trauner and Obwegeser in the 50s, received its first important modification by Dal Pont soon after. Minor changes were proposed on design and instrumentation, as well fixation methods. Puricelli described in 2007 a significant change in design and fixation for this technique: an extension ranging from 15 to 20 millimeters forward of the buccal osteotomy, to the first molar region, fixed by one miniplate nearby the mental foramen.

Methods: Resume the practice using the technique since 2001. Present laboratory data sustaining rationales for the method.

Results: The proposed design allowed for plate fixation in a flat anatomic surface on the lateral mandibular body, of easy direct access and instrumentation. The extension facilitated osteosynthesis in cases of concomitant third molar extraction. Plate removal, when necessary, was easier to accomplish. Laboratory data using finite element suggested this fixation to be very stable.

Conclusions: The mandibular osteotomy suggested by Puricelli is a suitable method for mandibular corrections, with advantages over the classic design.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Experience with mandibular sagital osteotomy proposed by Puricelli
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