SSRO is well known and very commonly used surgical technique worldwide for repositioning mandibular dental arch in both directions by advancement and setback movement of mandibular body [40]. SSRO provide a broad medullary contact between the bony segments that ensures stable healing capability. Internal fixation of bony segments eliminates or reduces the duration of intermaxillary fixation (IMF), plus a predictable immediate postoperative occlusion is achievable. The risk of neurovascular bundle injury is higher compared to intraoral vertical ramus osteotomy (IVRO) [41], and the risk of unfavorable fracture during the split between the bony segments was reported at 0.9% [42]. The risk of complications is reduced when experienced surgeons perform the procedure. Reproducing the original con- dylar position is difficult, and too much pressure can be placed against the articular disc or unfavorable condylar position can be created during SSRO. These conditions can potentially result in joint noise or pain, and can worsen any preexisting TMD symptoms [43-47].