Abstract
Classical surgical techniques for the treatment of pronounced retroposition of the mandible with or without temporomandibular joint (TMJ) pathologies have a significant recurrence rate. In extreme cases of this pathology, alloplastic TMJ reconstruction in combination with other procedures of dysgnathic surgery enables a safe and stable correction of mandibular malocclusions and simultaneous reconstruction of the TMJ, albeit with inherent invasiveness and risk profile. An alternative sequential treatment concept for three-dimensional distraction of the mandible in combination with Le Fort I osteotomy and Wing osteotomy in cases of pronounced mandibular retroposition and/or hypoplastic TMJs is presented. In approximately 900 cases operated on with the described technique, no clinically relevant recurrence rate has been observed to date. TMJ replacement that may become necessary later on is not compromised by the operations presented here.
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