This study describes a modification of the Bilateral Sagittal Split Osteotomy (BSSO) described by Obwegeser-Dal Pont, using a caudal horizontal osteotomy, under the lingula. This osteotomy is done following the anatomy of the inferior alveolar nerve in this area, to avoid nerve damage, based on reported IAN anatomy.

The aim of this study was to evaluate the sensory changes in 200 patients after BSSO using the modified technique during a two years follow up period. Patients underwent almost every possible move that includes the mandibular ramus in a horizontal plane.

There is no statistical difference between the sensory changes presented in the literature with Obwegeser-Dal Pont BSSO, and our modification.

The modification shows some advantages, mainly reducing the risk of subcondylar fractures, smaller incisions, provides an excellent visualization of the surgery field, and reduces the operating time.

We can conclude that the modification can be used in any mandible with normal anatomy, and it will not be affected by the mandible size, patients sex, or patient age.

Conflict of interest: None declared.