[Rehabilitation of patients with lower asymmetrical macrognathia]

Unilateral subcondylar vertical osteotomy of the mandibular ramus was performed in 26 patients with asymmetric mandibular prognathism (AMP). 16 of 26 patients had temporomandibular joint (TMJ) symptoms before surgery. Asymmetric mandibular prognathism was combined with maxillary micro-retrognathism in 15 patients. Condyle position was evaluated by pre- and postoperative computed tomography (CT) data. Unlike mandibular sagittal split osteotomy with rigid fixation, the vertical subcondylar osteotomy with wire osteosyntheses allows to keep preoperative condylar head position on the side of hypertrophy and thus to prevent and eliminate TMJ symptoms postoperatively. Wire osteosynthesis promotes the most complete mechanism of adaptation and self-regulation of TMJ elements in surgical treatment of patients with asymmetric mandibular prognathism. All 26 patients had no TMJ symptoms postoperatively.