Maxillary advancement for mandibular prognathism: indications and rationale.

Area of Science:

• Maxillofacial surgery
• Orthognathic surgery
• Craniofacial reconstruction

Background:

• Traditional mandibular prognathism correction involves mandibular setback, potentially reducing facial volume and soft tissue support.
• This can lead to undesirable aesthetic outcomes like loss of skeletal definition.

Purpose of the Study:

• To evaluate maxillary advancement as an alternative surgical technique for mandibular prognathism.
• To assess the aesthetic and skeletal outcomes of this approach.

Main Methods:

• 18 patients with mandibular prognathism underwent Le Fort I maxillary advancement.
• Genioplasty was performed concurrently to address vertical chin height and/or lateral shift.
• Cephalometric analysis and clinical follow-up (mean 16.2 months) were used to assess outcomes.

Main Results:

• Maxillary advancement restored maxillomandibular harmony and facial convexity without sacrificing skeletal volume.
• Patients exhibited well-supported soft tissues and defined skeletal features post-surgery.
• Cephalometric data indicated persistent mandibular enlargement and anterior facial divergence, yet overall facial proportion was achieved.

Conclusions:

• Maxillary advancement is a viable and effective surgical option for selected patients with mandibular prognathism.
• This technique preserves skeletal volume and enhances soft tissue support, leading to improved aesthetic results.
• It provides an alternative to mandibular setback, addressing skeletal disproportion while maintaining facial aesthetics.