General Rules in Sagittal Splitting – Five Steps

The operation for sagittal splitting of the mandible is composed of a logical sequence of surgical steps that must be consistently followed during each splitting procedure in order to operate successfully, with clarity and safely. Five surgical steps can be distinguished, from incision to osteosynthesis. Even the incision can be decisive for obtaining a sufficient overview of the surgical area, which is located on both sides of the ascending mandibular branch. The spaces between the masticatory muscles and the mandible must be created technically in such a way that the overview is not impeded or even made impossible by bleeding or remaining soft tissue attachments. The identification of the vascular and nerve bundle at the mandibular foramen must be ensured. Only then is the mandible split with usually three osteotomy lines lingually, buccally and the connection cut successful.