Influence Of Lingual Split Pattern On Skeletal Stability After Bsso

This retrospective cohort study investigated the influence of different lingual split patterns on skeletal stability after bilateral sagittal split osteotomy (BSSO) in patients with skeletal Class III malocclusion. The sample comprised 159 consecutively treated patients between November 2016 and December 2024 were included. Lingual fractures were classified using the Lingual Split Scale (LSS). The patient's fracture line was consistent on both sides. Lateral cephalograms were obtained preoperative (T0), within one week postoperative (T1), and six months postoperative (T2). Statistical analyses, including ANOVA and χ² tests, assessed the relationship between lingual split patterns and postoperative skeletal stability. This study was approved by the Human Ethics Review Committee (approval number WDKQ2025-B14). Postoperative relapse of the mandible in a counterclockwise direction. The maxilla showed good skeletal stability after BSSO, while patients in the LSS2 group presented significantly greater forward mandibular relapse in the horizontal direction compared to the LSS1 and LSS3 groups (P < 0.05). Notably, the mean facial angle (FMA) increased more significantly in the LSS2 group postoperatively (P < 0.05). The findings suggest that surgeons should aim for LSS1 and LSS3 patterns, as it may reduce postoperative skeletal relapse, thereby improving outcomes in orthognathic surgery. A stringent follow-up on LSS2 patients is recommended to monitor potential relapse.