J Oral Maxillofac Surg 70:696-702, 2012 Cutaneous Sensibility Impairment After Mandibular Sagittal Split Osteotomy: A Prospective Clinical Study of the Spontaneous Recovery Marcelo Silva Monnazzi, DDS, PhD, MsC,* Mario Francisco Real-Gabrielli,† Luis Augusto Passeri,‡ and Marisa Aparecida Cabrini Gabrielli§ Purpose: The aim of this prospective study was to objectively evaluate the inferior alveolar nerve (IAN) sensory disturbances in patients who underwent sagittal split ramus osteotomy (SSRO) and its sponta- neous recovery and to define the incidence of sensibility loss, time, and area at which the recovery occurs. Patients and Methods: Clinical evaluation of the IAN sensory disturbance was undertaken preoper- atively and at the first week, fourth week, 2 months, and 6 months postoperatively in 30 patients who underwent SSRO at the Oral and Maxillofacial Surgery Division of the Araraquara Dental School--Unesp and at the Plastic Surgery Division of the Medical Sciences School--Unicamp. The 30 patients were examined at all periods regarding the IAN functionality by Semmes-Weinstein testing. Results: The mean age of the patients included in this study was 29.36 years old. All patients showed sensibility loss at the 7-day evaluation time. The comparison between sides, gender, and age did not show any significant difference. In most of the examined zone, the data collected at 6 months were statistically similar to the data collected at the preoperative period. All zones presented significant recovery, starting from 30 days after surgery. Twenty patients had total spontaneous recovery at the final period, in all examined zones. Conclusions: The SSRO presents the disadvantage of temporary paresthesia; however, spontaneous nerve function recovery does occur. The Semmes-Weinstein test is a reliable, inexpensive, and easy-to- apply tool, which can be used for clinical evaluation on a daily basis at offices and hospitals. © 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:696-702, 2012 With safe and reliable results, orthognathic surgery is fre- quently used for the treatment of dentofacial deformities. Each osteotomy has its peculiarities regarding its execution or regarding the follow-up of the patients. These peculiar- ities have been studied in an attempt to make the proce- dures easier, safer, and more predictable. Regarding the mandibular ramus osteotomy tech- niques, many studies have been performed to deter- mine their internal fixation, stability, prediction of results, and complications. Paresthesia of the inferior alveolar nerve (IAN) is one of the most common and feared complications of those techniques. The bilateral sagittal split ramus osteotomy (SSRO) is a technique performed by intraoral approach, avoiding facial nerve contact. Internal fixation may be performed by different means, such as bicortical *Oral and Maxillofacial Surgeon, Faculty of Medical Sciences, Unicamp, Brazil. †Professor of the Division of Oral and Maxillofacial Surgery, Araraquara Dental School, Unesp, Brazil. ‡Professor of Oral and Maxillofacial Surgery, Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, Uni- camp, Brazil. §Assistant Professor, Division of Oral and Maxillofacial Surgery, Araraquara Dental School, Unesp, Brazil. Address correspondence and reprint requests to Dr Monnazzi: Rua Humaitá, 1680, 2 andar, Departamento de Diagnóstico e Ciru- rgia, Faculdade de Odontologia de Araraquara (UNESP), Araraquara SP, Brazil, CEP 14801-903; e-mail: monnazzi@ig.com.br © 2012 American Association of Oral and Maxillofacial Surgeons 0278-2391/12/7003-0$36.00/0 doi:10.1016/j.joms.2011.02.071 696