Mandibular Angle Osteotomy via Intraoral Approach: A 15-Year Experience from a Single Plastic Surgery Center in China

Mandibular angle osteotomy (MAO) using an intraoral approach is a common procedure for correcting square facial contours in the Asian population. While previous retrospective studies have primarily focused on complications rates, limited research has examined time-related trends and the epidemiological characteristics of the surgical population. A comprehensive study with a large sample size and long-term follow-up is crucial to enhance outcomes, minimize complications, provide evidence-based insights, and consolidate clinical experience.

This retrospective study reviewed 3,501 MAO cases performed via an intraoral approach between January 2008 and December 2022. Patients were categorized into three cohorts based on admission dates: group A (January 2008 to December 2012), group B (January 2013 to December 2017), and group C (January 2018 to December 2022). Demographic data, complication rates, and patient-reported satisfaction scores were analyzed across the groups.

The average ages for groups A, B, and C were 27.38 ± 6.94, 27.41 ± 6.42, and 28.57 ± 6.65 years, respectively, with group C patients being significantly older than those in group B (P < 0.001). Gender distribution showed 48 males and 825 females in group A; 93 males and 1,097 females in group B; and 122 males and 1,316 females in group C, with significant difference between groups A and B (P = 0.039). Complication rates were 13.05% (114 cases) in group A, 5.54% (66 cases) in group B, and 2.50% (36 cases) in group C. Postoperative satisfaction scores for groups A, B, and C were 3.32 ± 0.64, 3.86 ± 0.54, and 4.42 ± 0.58, respectively, with significant improvements across groups (P < 0.05).

The demand for MAO has steadily increased, particularly among individuals aged 21 to 40, with a predominance of female patients. Expanding indications have led to more cases involving middle-aged, elderly, and male patients. Advancements in surgical techniques have contributed to better aesthetic outcomes and lower complication rates. The use of modified osteotomy procedures and digital technologies has enabled safer, more precise surgeries across diverse populations, resulting in significant improvements in lower facial contours.

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