Simultaneous Removal of Third Molars During a Sagittal Split Does Not Increase the Incidence of Bad Splits in Patients Aged 30 Years or Older

Purpose An increasing number of patients who are 30 years old or older have been presenting for orthognathic surgery, some of whom have impacted third molars. The purpose of our report was to review the incidence of bad splits in this age group, both with and without third molars (3Ms). Materials and Methods A retrospective cohort analysis of all patients who had undergone sagittal split osteotomy (SSO) who were 30 years old or older was performed. The inclusion criteria were age 30 years or older and performance of an SSO. Those with incomplete data or who were younger than 30 years old were excluded. A history and radiographic review was performed to find cases with a bad split that had occurred during the surgical procedures. The fractures were correlated with the presence or absence of the lower 3Ms, the degree of impaction of the 3Ms, and patient age and gender. For this aged sample, the variables of 3M presence and gender were analyzed using the Fisher exact test. For patient age, analysis of variance was applied, and for the degree of impaction, the Pearson test was used. All the tests used the level significance of 0.05%. Results Of the 220 patients who underwent SSO during the study period, 52 were older than 30 years (24%). Of these, 8 patients (15%) had had at least 1 3M present at surgery. Most of the patients had undergone sagittal splits without complications. A total of 3 patients had had bad splits in this sample, 1 of whom had a 3M present at surgery and 2 of whom did not. No association was found between the occurrence of a bad split and the variables studied, including the presence of a 3M (P =.089), degree of impaction (P = .074), age (P =.963), and gender (P =.266). Conclusions From the results in this small subset of patients, 3Ms can be removed in patients older than 30 years concomitant with bilateral SSO.