The bone pencil and the bone surgeon.

While helpful for preoperative skin markings, methylene blue is washed away by irrigation and tissue fluids during bony reconstruction. The bone pencil is an ideal marker for hard tissue because it is indelible to irrigation. Further, the surgeon may draw with ease in areas of limited access (i.e., sagittal split and intraoral vertical ramus osteotomies). The pencil can be obtained from most art suppliers. No adverse effects from use of the pencil have been noted in any of our patients.