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Mandibular midline osteotomy for correction of bimaxillary transverse discrepancy: a technical note

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2023, v.49 no.3, pp.107-113
https://doi.org/10.5125/jkaoms.2023.49.3.107
Mrunalini Ramanathan (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan)
Rie Sonoyama-Osako (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan)
Yukiho Shimamura (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan)
Taro Okui (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan)
Takahiro Kanno (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan)

Abstract

Bimaxillary transverse width discrepancies are commonly encountered among patients with dentofacial deformities. Skeletal discrepancies should be diagnosed and managed appropriately with possible surgical corrections. Transverse width deficiencies can present in varieties of combinations involving the maxilla and mandible. We observed that in a significant proportion of cases, the maxilla is normal, and the mandible showed deficiency in the transverse dimension after pre-surgical orthodontics. We designed novel osteotomy techniques to enhance mandibular transverse width correction, as well as simultaneous genioplasty. Chin repositioning along any plane is applicable concomitant with mandibular midline arch widening. When there is a requirement for larger widening, gonial angle reduction may be necessary. This technical note focuses on key points in management of patients with transversely deficient mandible and the factors affecting the outcome and stability. Further research on the maximum amount of stable widening will be conducted. We believe that developing evidence-based additional modifications to existing conventional surgical procedures can aid precise correction of complex dentofacial deformities.

keywords
Orthognathic surgery, Mandibular osteotomy, Maxillary osteotomy, Transverse correction

Journal of the Korean Association of Oral and Maxillofacial Surgeons