{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T12:48:18Z","timestamp":1792932498171,"version":"4.5.0"},"reference-count":45,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cranio-Maxillofacial Surgery"],"published-print":{"date-parts":[[2022,7]]},"DOI":"10.1016\/j.jcms.2022.06.009","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T02:05:50Z","timestamp":1656727550000},"page":"543-549","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":14,"title":["Bad splits in bilateral sagittal split osteotomy: A retrospective comparative analysis of the use of different tools"],"prefix":"10.1016","volume":"50","author":[{"given":"Giovanni","family":"Salzano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2652-4198","authenticated-orcid":false,"given":"Giovanni","family":"Audino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4198-2288","authenticated-orcid":false,"given":"Marco","family":"Friscia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-145X","authenticated-orcid":false,"given":"Luigi Angelo","family":"Vaira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Biglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Maglitto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9444-0052","authenticated-orcid":false,"given":"Umberto","family":"Committeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Piombino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-4825","authenticated-orcid":false,"given":"Paola","family":"Bonavolont\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Petrocelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Perrotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Califano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcms.2022.06.009_bib1","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1016\/j.joms.2014.05.008","article-title":"Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy","volume":"72","author":"Aarabi","year":"2014","journal-title":"J.\u00a0Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib2","doi-asserted-by":"crossref","first-page":"e284","DOI":"10.1016\/j.jcms.2013.10.007","article-title":"Influence of osteotomy procedure and surgical experience on early complications after orthognathic surgery in the mandible","volume":"42","author":"Al-Nawas","year":"2014","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib3","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jcms.2017.10.004","article-title":"Structural and ultrastructural analyses of bone regeneration in rabbit cranial osteotomy: piezosurgery versus traditional osteotomes","volume":"46","author":"Anesi","year":"2018","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib4","first-page":"189","article-title":"Histomorphometric evaluation of bone grafts harvested by different methods","volume":"55","author":"Berengo","year":"2006","journal-title":"Minerva Stomatol."},{"key":"10.1016\/j.jcms.2022.06.009_bib5","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.ijom.2012.09.020","article-title":"Variations in the anatomical dimensions of the mandibular ramus and the presence of third molars: its effect on the sagittal split ramus osteotomy","volume":"42","author":"Beukes","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib6","first-page":"1742","article-title":"An in\u00a0vitro comparison study of the use of a drill or a saw in the Hunsuck-Dal Pont modification of the Obwegeser sagittal split osteotomy in pig mandibles","volume":"75","author":"B\u00f6ckmann","year":"2017","journal-title":"J.\u00a0Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s10006-011-0287-4","article-title":"Risk factors and prevention of bad splits during sagittal split osteotomy","volume":"16","author":"Chrcanovic","year":"2012","journal-title":"Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jcms.2020.11.010","article-title":"Postoperative evaluation of ER:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third molar extractions","volume":"49","author":"Civak","year":"2021","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib9","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.ijom.2019.05.011","article-title":"How does bone thickness affect the split pattern of sagittal ramus osteotomy?","volume":"49","author":"Cunha","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib10","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jcms.2017.11.023","article-title":"Accuracy of computer-assisted orthognathic surgery","volume":"46","author":"De Riu","year":"2018","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib11","doi-asserted-by":"crossref","first-page":"e265","DOI":"10.1016\/j.bjoms.2020.07.022","article-title":"New protocol for in-house management of computer assisted orthognathic surgery","volume":"58","author":"De Riu","year":"2020","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib12","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.tripleo.2010.02.003","article-title":"Occurrence of bad splits during sagittal split osteotomy","volume":"110","author":"Falter","year":"2010","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"10.1016\/j.jcms.2022.06.009_bib13","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.ortho.2019.08.016","article-title":"Complications in orthognathic surgery: a retrospective study of 5025 cases","volume":"17","author":"Ferri","year":"2019","journal-title":"Int. Orthod."},{"key":"10.1016\/j.jcms.2022.06.009_bib14","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s10006-017-0614-5","article-title":"Complications after orthognathic surgery: our experience on 423 cases","volume":"21","author":"Friscia","year":"2017","journal-title":"Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib15","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.ijom.2012.12.004","article-title":"Ultrasonic orthognathic surgery: enhancements to established osteotomies","volume":"42","author":"Gilles","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib16","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jormas.2017.06.009","article-title":"Is the piezoelectric device the new standard for facial osteotomies?","volume":"118","author":"Gonzalez-Lagunas","year":"2017","journal-title":"J\u00a0Stomatol Oral Maxillofac Surg"},{"key":"10.1016\/j.jcms.2022.06.009_bib17","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.jcms.2016.08.007","article-title":"Influence of inferior border cut on lingual fracture pattern during bilateral sagittal split osteotomy with splitter and separators: a prospective observational study","volume":"44","author":"Houppermans","year":"2016","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib18","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.bjoms.2020.08.107","article-title":"Risk factors of bad splits during sagittal split ramus osteotomy: a retrospective study of 964 cases","volume":"59","author":"Jiang","year":"2021","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib19","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.ijom.2005.04.016","article-title":"Complications associated with segmentation of the maxilla: a retrospective radiographic follow up of 82 patients","volume":"34","author":"Kahnberg","year":"2005","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib20","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1016\/j.joms.2007.05.030","article-title":"Incidence of complications and problems related to orthognathic surgery","volume":"65","author":"Kim","year":"2007","journal-title":"J.\u00a0Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.bjoms.2007.09.011","article-title":"Risk factors for a bad split during sagittal split osteotomy","volume":"46","author":"Kriwalsky","year":"2008","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib22","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s10006-008-0123-7","article-title":"Piezoosteotomy in Orthognathic surgery versus conventional saw and chisel osteotomy","volume":"12","author":"Landes","year":"2008","journal-title":"Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib23","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jcms.2016.12.018","article-title":"Comparison between piezosurgery and conventional osteotomy in cranioplasty with fronto-orbital advancement","volume":"44","author":"Martini","year":"2017","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib24","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.bjoms.2012.10.009","article-title":"Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients","volume":"51","author":"Mensink","year":"2013","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib25","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/coa.13001","article-title":"Prospective multicentre study on barbed reposition pharyngoplasty standing alone or as a part of multilevel surgery for sleep apnoea","volume":"43","author":"Montevecchi","year":"2018","journal-title":"Clin. Otolaryngol."},{"key":"10.1016\/j.jcms.2022.06.009_bib26","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.1097\/SCS.0000000000004238","article-title":"Complications in orthognathic surgery","volume":"29","author":"Olate","year":"2018","journal-title":"J.\u00a0Craniofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib27","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/j.jcms.2017.06.011","article-title":"Piezoelectric versus conventional techniques for orthognathic surgery: systematic review and meta-analysis","volume":"45","author":"Pagotto","year":"2017","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib28","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1053\/joms.2001.26704","article-title":"Incidence of complications and problems related to orthognathic surgery: a review of 655 patients","volume":"59","author":"Panula","year":"2001","journal-title":"J.\u00a0Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib29","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jcms.2013.06.013","article-title":"Randomized clinical study comparing piezosurgery and conventional rotatory surgery in mandibular cyst enucleation","volume":"42","author":"Pappalardo","year":"2014","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib30","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/j.joms.2008.04.010","article-title":"Retained third molars with orthodontics and orthognathic surgery","volume":"66","author":"Parker","year":"2008","journal-title":"J.\u00a0Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib31","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.ijom.2009.07.013","article-title":"3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible","volume":"38","author":"Plooij","year":"2009","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib32","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.ijom.2016.05.003","article-title":"Occurrence of a \u201cbad\u201d split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients","volume":"45","author":"Posnick","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib33","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S1079-2104(98)90057-9","article-title":"Presence of impacted teeth as a determining factor of unfavorable splits in 1256 sagittal-split osteotomies","volume":"85","author":"Precious","year":"1998","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"10.1016\/j.jcms.2022.06.009_bib34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.coms.2014.08.008","article-title":"Complications in orthognathic surgery. A report of 1000 cases","volume":"26","author":"Robl","year":"2014","journal-title":"Oral Maxillofac. Surg. Clin."},{"key":"10.1016\/j.jcms.2022.06.009_bib35","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.bjoms.2018.07.011","article-title":"Bimaxillary orthognathic surgery with a conventional saw compared with the piezoelectric technique: a longitudinal clinical study","volume":"56","author":"Rossi","year":"2018","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib36","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.ijom.2017.03.024","article-title":"Comparison between piezoelectric surgery and conventional saw in sagittal split osteotomies: a systematic review","volume":"46","author":"Silva","year":"2017","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib37","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ijom.2021.07.002","article-title":"Does the use of a piezoelectric saw improve neurosensory recovery following sagittal split osteotomy?","volume":"51","author":"Sobol","year":"2022","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib38","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.jcms.2014.02.011","article-title":"Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery","volume":"42","author":"Spinelli","year":"2014","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib39","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.ijom.2016.02.011","article-title":"Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors","volume":"45","author":"Steenen","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib40","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1097\/SCS.0000000000002648","article-title":"Does simultaneous third molar extraction increase intraoperative and perioperative complications in orthognathic surgery?","volume":"27","author":"Steinbacher","year":"2016","journal-title":"J.\u00a0Craniofac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib41","first-page":"207","article-title":"Technological characteristics and clinical indications of piezoelectric bone surgery","volume":"53","author":"Vercellotti","year":"2004","journal-title":"Minerva Stomatol."},{"key":"10.1016\/j.jcms.2022.06.009_bib42","doi-asserted-by":"crossref","first-page":"e359","DOI":"10.1016\/j.jcms.2014.03.019","article-title":"Presence of mandibular third molars during bilateral sagittal split osteotomy increases the possibility of bad split but not the risk of other post-operative complications","volume":"42","author":"Verweij","year":"2014","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib43","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.jcms.2016.04.023","article-title":"Risk factors for common complications associated with bilateral sagittal split osteotomy: a literature review and meta-analysis","volume":"44","author":"Verweij","year":"2016","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib44","doi-asserted-by":"crossref","DOI":"10.1007\/s00266-021-02742-1","article-title":"Risk factors analysis for different types of unfavorable fracture patterns during sagittal split ramus osteotomy: a retrospective study of 2008 sides","author":"Wang","year":"2022","journal-title":"Aesthetic Plast. Surg."},{"key":"10.1016\/j.jcms.2022.06.009_bib45","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1016\/j.jcms.2019.11.012","article-title":"Complications associated with orthognathic surgery: a retrospective study of 485 cases","volume":"47","author":"Zaroni","year":"2019","journal-title":"J.\u00a0Cranio-Maxillo-Fac. Surg."}],"container-title":["Journal of Cranio-Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1010518222000944?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1010518222000944?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:44:52Z","timestamp":1760885092000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1010518222000944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":45,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["S1010518222000944"],"URL":"https:\/\/doi.org\/10.1016\/j.jcms.2022.06.009","relation":{},"ISSN":["1010-5182"],"issn-type":[{"value":"1010-5182","type":"print"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Bad splits in bilateral sagittal split osteotomy: A retrospective comparative analysis of the use of different tools","name":"articletitle","label":"Article Title"},{"value":"Journal of Cranio-Maxillofacial Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcms.2022.06.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}