ArticleHead & face medicine2025
Investigation of the effect of impacted third molar position and orientation on bad split fractures in sagittal split ramus osteotomy using finite element analysis.
Article in Head & face medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aims to evaluate the impact of different angular orientations and buccolingual positions of impacted third molars on the incidence of bad splits during sagittal split ramus osteotomy using finite element analysis. MATERIALS AND
methodsA total of 12 mandibular models were constructed, each representing a unique combination of third molar orientations (vertical, distoangular, horizontal, mesioangular) and positions (buccal, lingual, central). A force of 20 N was applied from the osteotomy line toward the proximal and distal segments to simulate the working principle of the Smith Spreader instrument.
resultsThe maximum principal stress followed the order: vertical > distoangular > horizontal > mesioangular. In terms of positional stress distribution, the buccal position generated the highest stress, followed by lingual and central positions. Similar trends were observed across all stress criteria evaluated.
conclusionThe orientation and position of impacted third molars have a direct effect on the risk of bad splits during SSRO. Mesioangular and centrally positioned teeth were associated with lower stress levels, indicating lower risk, while vertically oriented and buccally or lingually positioned molars showed significantly higher stress concentrations. Thus, extraction of high-risk impacted third molars prior to surgery is recommended to reduce the likelihood of complications.
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