Journal of Cranio-Maxillofacial Surgery, cilt.54, sa.1, 2026 (SCI-Expanded, Scopus)
Sagittal split ramus osteotomy is a widely used procedure in orthognathic surgery; however, conventional techniques are associated with notable morbidity, including bleeding, edema, and pain. Recently, minimally invasive techniques have been described to reduce surgery-related morbidities and improve patients’ outcomes. This randomized, double-blind, controlled, split-mouth trial aimed to compare the conventional approach with a minimally invasive sagittal split osteotomy (MISSRO) in terms of surgical efficiency and postoperative outcomes. In each of the thirty-six patients included in the study, a conventional sagittal split osteotomy (SSRO) was performed on one side of the mandible, and a MISSRO was performed on the contralateral side. The MISSRO technique was characterized by a short mucosal incision, minimal soft-tissue dissection, and a low and short osteotomy. Operative time and bleeding were statistically significantly lower on the minimally invasive side ( p < 0.001). Postoperative edema measurements on days 1, 7, 14, and 30 were also statistically significantly reduced ( p < 0.001). Pain scores were statistically significantly lower at the first postoperative hour ( p = 0.002) on the minimally invasive side, with no differences at later time points. The findings suggest that MISSRO is a safe and effective alternative to the conventional method, enhancing recovery by reducing tissue trauma and improving perioperative outcomes.