A Modification In Bilateral Sagittal Split Ramus Osteotomy Setback

Abstract

Mandibular prognathism combined with a retrognathic maxilla is a skeletal discrepancy that is difficult to correct. A 21-year-old patient presented with a skeletal Class III malocclusion with a large mandible, Angle’s Class III malocclusion, retroclined lower incisors, proclined upper incisors, crowding of maxillary and mandibular teeth. The patient was treated by bilateral sagittal split setback osteotomy of the mandible with surgery first approach via non- extraction therapy.

The purpose of this case report is to describe and discuss a novel technique of performing mandibular setback by removing the bone in distal fragment rather reducing the bone in the proximal fragment for surgical management of transverse maxillary deficiency and mandibular prognathism in the treatment of skeletal Class III malocclusion in a mature patient.