Vertical ramus elongation and mandibular advancement by endobuccal approach: Presentation of a new osteotomy technique

J Stomatol Oral Maxillofac Surg. 2017 Feb;118(1):66-69. doi: 10.1016/j.jormas.2016.12.003. Epub 2017 Feb 3.

Abstract

Introduction: Several surgical procedures have been proposed for the treatment of hyperdivergent dentoskeletal deformities. We propose a new osteotomy technique allowing for lengthening and advancement of the mandibular ramus by intra-oral approach.

Surgical procedure: This technique differs from the conventional sagittal split osteotomyin that which the anterior osteotomy line is not continued until the basilar edge but stopped 5-6mm above it. Cutting of the pterygomasseteric sling is systematically done allowing for the lowering of the mandibular angle. Osteosynthesis is performed by transjugal and intra-oral approaches, using two adjustable miniplates. Our supra-angular technique allows for both elongation of the ramus and advancement of the mandible. Unlike the vertical ramus osteotomy proposed by Caldwell-Letterman, external incision and intraoperative cervical hyperextension are not required.

Keywords: Angle Class 2; Malocclusion; Orthognathic surgery; Sagittal split osteotomy; Surgical procedure.

MeSH terms

  • Adult
  • Anesthesia, General
  • Cephalometry / methods
  • Female
  • Humans
  • Malocclusion, Angle Class II / surgery
  • Mandible / surgery
  • Mandibular Advancement / methods*
  • Mouth / surgery*
  • Orthognathic Surgical Procedures / methods*
  • Osteotomy, Sagittal Split Ramus / methods*
  • Vertical Dimension*