Finite element analysis of stress distribution in sagittal split Ramus osteotomy: the influence of impacted third molars

ObjectiveThis study aims to evaluate the effect of impacted third molars in different positions on stress distribution in the proximal and distal segments during sagittal split ramus osteotomy (SSRO) using finite element analysis.Materials and methodsFinite element stress analysis was used to create models with impacted third molars in different positions. In SSRO-applied models, a 20 N force was applied in opposite directions to the proximal and distal segments along the sagittal osteotomy line. The von Mises, Pmax, and Pmin stress values induced by the applied force in the proximal and distal segments were analyzed to assess their potential impact on the risk of unfavorable fractures.ResultsCompared to the control model, the highest stress values were observed on the buccal side of the proximal segment in the distoangular model and on the lingual side of the distal segment in the horizontal model. Analyzing the von Mises, Pmax, and Pmin stress values in all models, it was found that the highest stress concentrations occurred predominantly on the buccal side of the proximal segment.ConclusionDuring SSRO, horizontally positioned impacted third molars may increase stress values in the distal segment, potentially elevating the risk of unfavorable fractures. In all models, higher stress concentrations were observed in the buccal region of the proximal segment. These findings highlight the clinical importance of patient-specific evaluation of third molars prior to SSRO.