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A surgery-first approach using single-jaw rotational mandibular setback in low-angle mandibular prognathism
Gyeong-Su Kim1, Sung-Hoon Lim1, Seo-Rin Jeong1
1Department of Orthodontics, College of Dentistry, Chosun University, Gwangju, South Korea.
Summary
This study presents a novel approach for treating low-angle mandibular prognathism, replacing traditional two-jaw surgery with single-jaw mandibular setback and orthodontic manipulation. This method simplifies treatment for patients without maxillary deficiency.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- Surgical Planning and Simulation
Background:
- Low-angle mandibular prognathism is typically treated with simultaneous Le Fort I maxillary osteotomy and rotational mandibular setback surgery.
- Maxillary surgery can be avoided by using orthodontic intrusion of maxillary posterior teeth.
Observation:
- A 19-year-old female with low-angle mandibular prognathism and no maxillary deficiency was treated using a surgery-first approach.
- The surgical plan involved orthodontic rotation of the maxillary occlusal plane and simulation of postsurgical mandibular rotation.
Findings:
- Rotational mandibular setback surgery created a Class II open bite postoperatively.
- Palatal mini-implants and a lever were used for maxillary total arch distalization and molar intrusion during postsurgical orthodontic treatment.
Implications:
- This approach demonstrates that orthodontic rotation of the maxillary occlusal plane can replace maxillary surgery in specific cases.
- Single-jaw rotational mandibular setback surgery with a surgery-first approach is a viable alternative for select patients.
