Sagittal Split and Mandibular Advancement

Corrections of mandibular position are the domain of bilateral sagittal splitting osteotomy—BSSO. The Obwegeser-Dal Pont technique is considered the overall standard technique for mandibular advancement. The importance of alveolar segmental osteotomies has greatly decreased due to the differentiated orthodontic treatment options. The known risks of alveolar segmental osteotomies—loss of bone, teeth, fractures, and long-term damage to adjacent teeth—are not prevalent with today’s surgical correction of the jaw bases. Nevertheless, segment osteotomies can play a role, especially in extreme Class II/2 occlusal situations, to impact severely vertically exaggerated anterior segments and also to modify them in anteroposterior inclination. Negative occlusal curves (curve of Spee) can also be corrected by raising the anterior segment. Segment osteotomies can be combined with corrections of the mandibular base.