Correction of Mandibular Prognathism in Combination with Polydiastema Using Rectangular Body Ostectomy: Literature Review and Case Report

Objective: Mandibular prognathism is inadaptability between skull and mandible and is one phenotype of class III malocculsion. Polydiastema may be present together with class III malocclusion. Skeletal class III malocclusion with mandibular prognathism can be diagnosed by cephalometric parameters. Study Design: A 22-year-old man complaining about difficult mastication and speech was referred to Department of Oral and Maxillofacial Surgery. According to the cephalometric analysis of the patient in sagittal plane, maxilla was 3 mm behind and mandible was 1 mm ahead from the skull base. During presurgical orthodontic treatment, polydiastema was treated in maxilla and mandible. Result and Conclusions: Skeletal class III malocclusion requires an orthognathic surgical procedure including some techniques. One of these techniques is mandibular body ostectomy, which is performed often as a surgical procedure for skeletal class III malocclusion. Instead of sagittal split osteomy, the technique of madibular body ostectomy could be performed as an

Combined Therapy for Mandibular Prognathism:Sagittal Split Osteotomy with Excision of Tongue

In the evaluation of the beauty and functional integrity of the lower face, the oral cavity, teeth, mandible, maxilla, and the size and position of the tongue are important. The tongue locates forward and is larger than normal in prognathism, in which the jaw protrudes from the skull. It is not clear whether an enlarged tongue causes the open bite, protrusion or dental arch misalignment, or is a result of them. Here, we report two patients with mandibular prognathism and relative macroglossia, which were treated by mandibular setback surgery using a bilateral sagittal split osteotomy (BSSO) and excision of the tongue. This procedure achieved aesthetic improvement of the face and dentition.

Mandible prognathism saved a life： a case report

An unusual case of a suicidal firearm injury is presented, in which the victim placed the gun under his chin and fired. However, none of the vital structures of the head and face were injured because the victim＇s chin was considerably anterior to other facial structures as a result of a class Ⅲ facial deformity. This resulted in thetrajectory of the bullet being anterior to vital facial structures and not causing injury to those structures.

Combined surgical-orthodontic rehabilitation of cleidocranial dysplasia: 5 years follow-up

Cleidocranial dysplasia(CD) is an autosomal dominant syndrome which is characterized by several skeletal malformations such as non-closed fontanelles, skeletal abnormalities of the maxilla and mandible and absence of clavicles. Mid-facial hypoplasia and mandibular prognathism are mostly seen jaw abnormalities in CD. In this study, the combined orthodontic-surgical treatment of a patient with CD with class Ⅲ malocclusion and multiple unerupted primary and deciduous teeth is presented.

Changes of Transverse Mandibular Width in Set-Back Mandibular Surgery: Sagittal Split versus Intraoral Verticosagittal Osteotomy

Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral verticosagittal ramus osteotomy, it can minimize the movement of the proximal segment. The changes in the intergonal distance of mandible and the angle of the ramus flaring in two methods of osteotomy have been compared in this study. Materials and Methods: In this randomized clinical trial, included 60 patients (32 males) with mandibular prognathism and without any asymmetry were selected and divided into two groups (n = 30). One group underwent bilateral sagittal split ramus osteotomy technique to achieve mandibular setback and the other by the intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner-ramal angle in the transverse plane were measured on radiographs preoperatively and 1 and 12 weeks postoperatively. Data were analyzed using covariance test with the significance level set at P 0.1). Conclusion: Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle.

CHANGES IN AIRWAY SPACE FOLLOWING MANDIBULAR SETBACK USING SAGITTAL SPLIT OSTEOTOMY AND RIGID INTERNAL FIXATION

The changes in airway space following mandibular setback using sagittal split osteotomy and rigid internal fixation were studied in 28 Japanese patients with mandibular prognathism. The correlation between the amount of mandibular setback and airway space changes,as well as the correlation between the amount of airway space changes and relapse of pognion point during the following-up period were also studied. Lateral cephalometric radiographs were taken immediately before and shortly after surgery as well as 5 to 12 months postoperation. The cephalometric evaluations of airway space width and area were based on stable craniofacial landmarks. The mean setback of mandible was 8.3 mm in the right side,and 8. 2 mm in the left side. The mean amount of relapse of pogonion point during the following-up period was 0. 52 mm horizontally,and 0. 92 mm vertically. A significant decrease in airway space width and area,especially in the lower part of airway space was found following mandibular setback shortly after surgery. Although there was some increase both in airway space width and area during the following-up period,they did not increase to their original values. This suggests that the narrowing of airway space following mandibular setback using sagittal split osteotomy can be permanent. No significant correlation was found between the amount of mandibular setback and airway space changes. Since the relapse of pogonion point during the following-up period was too small,there is no significant correlation between it and the amount of airway space changes.