Simultaneous mobilization of the maxilla and mandible: surgical technique and results

Simultaneous mobilization of the entire maxilla and mandible is a versatile procedure that can be used to correct multiple dentofacial deformities. The procedure is especially useful in correcting open bite deformities, as well as sagittal, vertical, and transverse dysplasias of the maxilla and mandible, and cases of asymmetry involving both the maxilla and mandible. Mock surgery performed on cephalometric tracings and study models provide a blueprint for the planned surgery. The use of an interim splint, constructed from sectioned models mounted on a semiadjustable articulator from a face bow transfer, is advocated to aid in accurate placement of the maxilla. The correct position of the maxilla is required to determine the ultimate position of the mandible; there is no room for error with this step if the procedure is to be accurate. Stabilization of the mobilized segments by direct osseous fixation, suspension wires, and maxillomandibular fixation is suggested. Maintenance of rigid maxillomandibular fixation for six weeks combined with an additional four weeks of guided mandibular function with skeletal elastics assures proper healing and position of segments.