Sagittal Split Separators and Orthognathic Osteotomes

Instrument guides

Orthognathic Osteotomes and Separators: Sagittal Split, Le Fort and Maxillary Instruments

Which osteotomes, splitters and separators are used for the sagittal split and Le Fort osteotomies, how they differ, and the sizes we make.

Sagittal split and Le FortOsteotomes 2.5 to 20 mmLeft and right pairs

Orthognathic surgery moves the jaws by cutting them in planned lines. Osteotomes such as the Obwegeser, Dautrey and Tessier patterns complete the bone cuts. Splitting osteotomes and sagittal split separators, such as the Smith and Reyneke, open the mandibular split gently so it separates along the planned line. For the upper jaw, Rowe disimpaction forceps, Tessier maxillary levers and the Obwegeser maxillary mobilizer free and move the maxilla after a Le Fort I osteotomy.

Where do these operations come from?

Hugo Obwegeser pioneered the intraoral sagittal split osteotomy of the mandible in the 1950s and described the modern Le Fort I osteotomy of the maxilla, as his Royal College of Surgeons biography records. The Le Fort names come from René Le Fort's 1901 study of midface fracture lines. Paul Tessier, widely called the father of craniofacial surgery, extended these techniques to the whole face, as the Lurie Children's account of his legacy describes. Many of the instruments below carry Obwegeser's and Tessier's names.

Which instruments do we make?

Instrument	Sizes	Use
Obwegeser osteotome	2.5 to 6 mm, 15 cm	Fine bone cuts
Obwegeser splitting osteotome	7 or 10 mm	Completing and opening a split
Obwegeser wedge osteotome, blade osteotome	8 to 20 mm	Wedging and broad cuts
Obwegeser pterygoid osteotome	10 mm	Pterygomaxillary separation
Obwegeser orbital, nasal septum osteotome	4 to 11 mm	Orbit and septum in Le Fort cuts
Dautrey-Munro osteotomes, Dunn-Dautrey	4 to 16 mm	Ramus and mandible cuts
Tessier osteotome, Tessier calvarial splitter, Tessier-Kawamoto retromaxillary chisel	9 to 15 mm	Craniofacial and retromaxillary cuts
Martini chisel	3.7, 4.5, 7 mm	Fine bone work
Smith sagittal split separator, left, right, Smith ramus separator	Pairs; 12 mm blade	Opening the sagittal split
Reyneke separator, left, right	9 x 10 or 9 x 15 mm blades	Opening the sagittal split
Rowe disimpaction forceps, left, right, Hayton-Williams	Pairs	Mobilising the maxilla
Tessier maxillary lever, left, right, Obwegeser maxillary mobilizer	23 cm	Moving the maxilla forward
Turvey palatal expander, Jeter-Van Sickels	17 to 18 cm	Palatal and segmental work

Osteotome, splitter or separator?

An osteotome cuts. A splitter or separator is used once the cuts are made, to open the bone gradually along the planned line rather than letting it break unpredictably. Separators come in left and right pairs because the split runs on both sides of the mandible. For nasal and facial osteotomes and the mallets that drive them, see our osteotome guide and mallet guide.

How should they be cleaned?

Clean bone dust from blades and joints straight after use. Protect osteotome edges in a rack, and check separators and forceps for even closure. Never leave instruments in saline, because it causes corrosion. Our instrument care guide gives the full routine, and the CDC guidance on cleaning instruments before sterilization explains why cleaning comes before the autoclave.

Frequently asked questions

What is a sagittal split separator?

An instrument used to open the mandibular sagittal split gently once the cuts are made, so the bone separates along the planned line.

What are Rowe disimpaction forceps used for?

Gripping and mobilising the maxilla after a Le Fort I osteotomy or in midface fractures. They come as a left and right pair.

What is a pterygoid osteotome?

A curved osteotome used to separate the maxilla from the pterygoid plates.

Can these be autoclaved?

Yes. Protect the osteotome edges during sterilization.

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