Intellectual Foundations and Evolving Research Trends in Sagittal Split Ramus Osteotomy Modifications: A Bibliometric Analysis.

INTRODUCTION

Numerous modifications of sagittal split ramus osteotomy (SSRO) have been proposed, but their influence on subsequent research and the evolving focus of the literature remain unclear. This study examined the intellectual foundations, research themes, productivity, and collaboration patterns of SSRO modification research.

MATERIALS AND

METHODS

English-language publications indexed in WoSCC SCI-EXPANDED were identified through a primary search on October 7, 2026, a known-item check, and a supplementary search targeting older publications and short-format records on October 15, 2026. No lower publication year limit was applied. Two reviewers independently screened the records. Performance and citation analyses, including publication-year-normalized citations, used bibliometrix; reference co-citation and author keyword networks used VOSviewer.

RESULTS

The dataset comprised 506 publications from 72 sources spanning 1968-2026, including 51 publications identified through the supplementary search. Annual production increased particularly after 2010 and peaked in 2017; 2026 represented an incomplete publication year. Based on corresponding-author affiliations, the leading countries were the United States (n = 86), Japan (n = 57), and Brazil (n = 37). The most locally cited references were Epker (1977; n = 163), Trauner and Obwegeser (1957; n = 147), Hunsuck (1968; n = 140), and Dal Pont (1961; n = 136). Among the 248 publications containing author keywords, terms with later average publication years included virtual surgical planning, three-dimensional printing, patient-specific implants, and temporomandibular joint.

DISCUSSION: Classic technical descriptions remain prominent alongside increasing attention to digital planning and biomechanical evaluation. Citation patterns do not establish clinical superiority; comparative clinical studies are needed to determine whether newer modifications offer clinical advantages.