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The most common mandibular surgical osteotomy to advance the mandible is:

 # The most common mandibular surgical osteotomy to advance the mandible is ____. 
A. Le Fort I osteotomy 
B. Segmental maxillary osteotomy 
C. Bilateral sagittal split osteotomy 
D. Intraoral vertical ramus osteotomy 



The correct answer is C. Bilateral sagittal split osteotomy.

Bilateral sagittal split osteotomy (BSSO) is one of the most commonly performed and versatile mandibular procedures. It can be used for backward or forward correction of the mandible in isolation or in combination with a maxillary osteotomy. It is usually performed while the patient is under general anaesthesia. It was originally described by Trauner and Obwegeser in 1957. The procedure has since undergone numerous modifications, including those by Dalpont, Hunsuck, Bell and Epker.

Even when there are large advancements, bone grafting is rarely required because of the long bony interface between the two fragments. Indications for BSSO include mandibular advancement, setback and correction of asymmetry. It is contraindicated in ramus hypoplasia, narrow lateral to medial ramus thickness and severe asymmetries.

Ref: An Introduction to Oral and Maxillofacial Surgery SECOND EDITION, David A. Mitchell, Page 306


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