Does ramus thickness influence a bad split
Reviewed by Stuart Clark

This is a retrospective study investigating 94 sagittal split osteotomies (47 patients, 94 splits) and their fracture patterns. They noted that class II patients had a thinner medullary bone than class III patients, whilst greater bone volume and ramus thickness were associated with a more favourable split pattern. Ideal splits occurred in 68%, with bad splits in 4.3%. The remainder involved splits over the canal extending to the posterior ramus. The surgery did not use the widely accepted Dal Pont or Hunsuck modifications but instead employed the Posnick low and short osteotomy. Nonetheless, it is a reasonable observational study.

Do cortical and medullary bone volume, and retromolar and ramus thickness influence the sagittal split pattern? A retrospective analysis.
Cunha G, Husarek J, Maintz M, et al.
INT J ORAL MAXILLOFAC SURG
2026;55(9):1052–8.