Evaluation of the Inferior Alveolar Nerve Damages in Bilateral Sagittal Split Osteotomy and Distraction Osteogenesis Techniques Used For Mandibular Advancement

Bilateral sagittal split osteotomy (BSSO) and distraction osteogenesis (DO) are surgical techniques which are commonly used for mandibular advancement. During this procedure, the inferior alveolar nerve (IAN) which is the major innervations source of the mandibular bone and dentition, may be affected or injured at different level of severities. Such complications may lead to the paresthesia of the chin and lower lip regions or complaints of altered sensation that lasts longer than 12 months. Nerve damage is evaluated objectively by clinical methods or subjectively by self-reported questionnaires. However, large variations may appear when these methods are used simultaneously. Age, surgical technique, the amount of advancement and anatomical position of IAN have been reported as possible risk factors, particularly for BSSO. However, when used for similar purposes on randomly distributed patient groups, BSSO and DO did not differ significantly with respect to the percentage of long-lasting IAN disturbance. Comparative clinical studies that focus on the personal effects of sensory loss are needed in order to determine which technique should be preferred.