Total subapical mandibular osteotomy to correct class 2 division 1 dento-facial deformity

A severe Class 2 division 1 dento-facial deformity in an adult is normally treated by a combination of orthodontics and orthognathic surgery. The surgical procedure may involve either a single or double jaw osteotomy. The sagittal split osteotomy with forward mandibular slide has been the procedure of choice for many years for correcting the antero-posterior discrepancy between the dental arches. Although the total subapical mandibular osteotomy was described over 20 years ago, reports of its use in the literature are sparse. We report two cases to demonstrate that it can be the operation of choice for surgical correction of Class 2 dento-facial deformity in carefully selected cases. When performed correctly it can have very good aesthetic and functional results.