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


METHODS
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.
Department of stomatology and maxillofacial surgery, university hospital center of Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France. Electronic address: docteurfgrimaud@gmail.com.
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F
Grimaud
Department of stomatology and maxillofacial surgery, university hospital center of Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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H
Bertin
Department of stomatology and maxillofacial surgery, university hospital center of Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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F
Fauvel
Department of stomatology and maxillofacial surgery, university hospital center of Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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Corre
Department of stomatology and maxillofacial surgery, university hospital center of Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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JP
Perrin
D000328:Adult; D000768:Anesthesia, General; D002508:Cephalometry / Q000379:methods; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000601:surgery; D019186:Mandibular Advancement / Q000379:methods*; D009055:Mouth / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D014716:Vertical Dimension
Angle Class 2; Malocclusion; Orthognathic surgery; Sagittal split osteotomy; Surgical procedure