title: Second vertical osteotomy 15 years after initial operation.
abstract: A case of mandibular prognathism that existed 15 years after a previous attempt at correction has been presented. The initial procedure was the vertical osteotomy done via an extraoral approach. A second attempt at correction was undertaken with use of the same approach. The anatomic changes existing as a result of the first surgical procedure were of extreme interest. A decreased anteroposterior length of the sigmoid notch with posterior placement of the coronoid process was observed. Also, an increased thickness of the mandibular rami in a mediolateral plance was present. The clinical problems encountered as a result of these changes were difficulty in overlapping proximal and distal segments without definite osseous reductions and the inability to set back the mandible further without coronoidectomy. When these procedures were done, the patient's treatment was managed very successfully.
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008334:Mandible / Q000002:abnormalities* / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011378:Prognathism / Q000601:surgery*; D013997:Time Factors