ASSESSMENT OF NEUROSENSORY DISTURBANCES AFTER BSSO MANDIBULAR SETBACK: LOW MEDIAL CUT VS. HIGH MEDIAL CUT (RANDOMIZED CONTROLLED TRIAL)

This study aimed to evaluate the incidence of neurosensory disturbance (NSD) following two modifications of bilateral sagittal split mandibular osteotomy (BSSO)—low medial cut (Posnick modification) and high medial cut (standard)—in the immediate postoperative period and after a minimum follow-up of six months. Twenty patients with skeletal Class III deformity requiring mandibular setback were randomly divided into two equal groups. Subjective and objective testing for inferior alveolar nerve function was performed. The results showed that all patients (except four in the Posnick
group) exhibited some degree of NSD immediately postoperatively. However, at the 6-month follow-up, a complete recovery of NSD was reported in 74% of the low medial cut group and 35% of the high medial cut group. The low medial cut (Posnick) osteotomy demonstrated a shorter average osteotomy duration (20.30 minutes) compared to the
high medial cut (27.21 minutes) and allowed for better visualization of the inferior alveolar nerve with decreased medial dissection.. The study concludes that the low medial cut (Posnick) SSO is a valuable osteotomy technique, offering shorter osteotomy duration, decreased incidence of bad split, and better neurosensory recovery in the extended followup period compared to the traditional BSSO.