Is a Bilateral Sagittal Split Osteotomy(BSSO) Specifically movement of the distal segment an effective method of clockwise rotation of the mandible?

[Shirobon]

Curious if there are better methods, a flaw of my relates heavily to how acute my gonial angle is unfortunately

 

[yussimania]

It depends on relationship of OPA to MPA

 

[Shirobon]

It depends on relationship of OPA to MPA

What specifically?

 

[eology]

Curious if there are better methods, a flaw of my relates heavily to how acute my gonial angle is unfortunately

ig studying lookism is easy until the jawhacking part comes in
ill be here for years until i get my mma plan all made up

 

[eology]

Yes. A Bilateral Sagittal Split Osteotomy (BSSO) can be used to produce clockwise (CW) rotation of the mandible, but the rotation is usually achieved by repositioning the distal (tooth-bearing) segment relative to the proximal (condyle-bearing) segments, often in combination with changes to the maxilla if larger rotations are desired.
Here's how it works:

• Proximal segment: Contains the condyle, which remains seated in the temporomandibular joint.
• Distal segment: Contains the teeth and chin. During a BSSO, the surgeon moves this segment relative to the proximal segment.

For clockwise rotation (viewed from the patient's right side), the distal segment is positioned so that:

• The chin moves downward and backward.
• The mandibular plane angle increases.
• Lower anterior facial height increases.

This is a standard movement in orthognathic surgery and is commonly used for patients with:

• Deep bites.
• Short lower facial height.
• Cases where the chin is excessively prominent vertically or horizontally.
• Certain occlusal corrections.

Limitations​

A BSSO alone has some constraints:

• Small to moderate clockwise rotations are generally predictable.
• Large rotations are less stable because they can create gaps between the bone segments and place tension on the surrounding muscles and soft tissues.
• Significant clockwise rotation also tends to reduce the airway behind the tongue, so surgeons evaluate this carefully, particularly in patients at risk for obstructive sleep apnea.

In practice​

For substantial clockwise rotation, surgeons often combine procedures:

• Le Fort I osteotomy to reposition or rotate the maxilla.
• BSSO to position the mandible into the new bite.
• Occasionally a genioplasty to refine chin position.

This combination generally provides better occlusion, facial proportions, and skeletal stability than trying to achieve a large rotation with a mandibular procedure alone.
So, yes, movement of the distal segment during a BSSO is the mechanism by which mandibular clockwise rotation is achieved, but the amount of rotation that can be done effectively with BSSO alone is limited, and larger or more complex rotations are often performed as part of bimaxillary surgery.

//pasted the thread title into gpt prompt slop even if unsolicited

 

[Shirobon]

ig studying lookism is easy until the jawhacking part comes in
ill be here for years until i get my mma plan all made up

I mean its something i just thought about to fix alot of the flaws in my lower third, my chin is projected but because of the acuteness of my gonial angle it becomes an issue where it doesn't perfectly harmonize with my lip line or nose

i had originally planned a menthoplasty but didnt consider this

 

[yussimania]

What specifically?

Well let's say you have a very flat OPA - say 0° for example

And your MPA too is 0°

By doing let's say 10-12° of CWr of the OPA the MPA moves 1:1

So now you have 10-12° increase to your MPA

But this isn't 1:1 to your gonial angle

Because BSSO cut is not the entire mandible

 

[Shirobon]

Well let's say you have a very flat OPA - say 0° for example

And your MPA too is 0°

By doing let's say 10-12° of CWr of the OPA the MPA moves 1:1

So now you have 10-12° increase to your MPA

But this isn't 1:1 to your gonial angle

Because BSSO cut is not the entire mandible

oof i can kinda see how that would be a problem

 

[Shirobon]

So

Well let's say you have a very flat OPA - say 0° for example

And your MPA too is 0°

By doing let's say 10-12° of CWr of the OPA the MPA moves 1:1

So now you have 10-12° increase to your MPA

But this isn't 1:1 to your gonial angle

Because BSSO cut is not the entire mandible

what do u recommend?

 

[yussimania]

So


what do u recommend?

Would need to see scans and shieet