Hard and Soft Tissue Changes Following Maxillary Distraction Osteogenesis and Mandibular Setback with Bilateral...

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Craniofacial Surgery

Background:

• Severe developmental maxillary hypoplasia (MH) and mandibular prognathism (MP) often require complex surgical correction.
• Two-jaw surgery using distraction osteogenesis (DO) and orthognathic procedures can address significant skeletal discrepancies.

Purpose of the Study:

• To evaluate the efficacy of intraoral submerged devices in maxillary DO for patients with severe MH and MP.
• To analyze hard and soft tissue changes after combined maxillary DO and mandibular setback with bilateral sagittal split osteotomy (BSSO).

Main Methods:

• Five patients with severe MH and MP underwent a two-stage surgical treatment.
• Maxillary distraction osteogenesis (DO) was performed first, followed by mandibular setback using BSSO.
• Cephalometric analysis was used to assess skeletal and soft tissue changes preoperatively and postoperatively.

Main Results:

• Significant maxillary advancement (mean 11.4 mm at ANS) and mandibular setback were achieved.
• Facial profile improved, with normalization of the nasolabial angle and increased convexity.
• Upper and lower lip positions were favorably altered, contributing to enhanced facial aesthetics.

Conclusions:

• Combined maxillary DO and mandibular setback with BSSO effectively corrects severe jaw deformities.
• This surgical approach leads to improved facial balance and esthetics in patients with MH and MP.
• Intraoral DO devices are a viable option for managing complex craniofacial discrepancies.