Inverted-L osteotomy for correction of mandibular prognathism after relapse

As more orthognathic surgery is performed, more case of relapse can be expected. A case of re-operation of a recurrent prognathism has been reported. An alternative surgical approach was used because the planned operation could not be accomplished. However, the implications of the use of the technique are broader than the single example given in this report. The inverted-L technique, because of its similarity to the combined oblique osteotomy and coronoidectomy for correction of extreme prognathism, provides an alternative procedure that leaves a greater proportion of the masticatory musculature in its natural position. In addition, with the development of techniques and instrumentation for intraoral approaches to oblique osteotomy of the ramus, the feasibility of an intraoral inverted-L osteotomy becomes apparent and the approach merits further consideration.