Poster 206: Revisit of Mandibular Body Osteotomy for Correction of Mandibular Prognathism: A Case Report

Abstract

Mandibular body osteotomy became less common recently for correction of mandibular prognathism because of complications such as inferior alveolar nerve injury and developing more effective surgical procedures such as mandibular sagittal split ramus osteotomy. However, there are several cases which seemed to be an indication of this operation. In this paper, we report a case of mandibular prognathism which we performed the body osteotomy with inferior alveolar neurovascular bundle decompression in order to minimize damage to this structure. An eighteen year old man showed mandibular prognathism but the occlusion in the molar region was normal. After preoperative orthodontic treatment, the body osteotomy was performed in the missing second premolar space. Mucoperiosteal finger flap was reflected at the crest of the space to expose the inferior border of the mandible and around the mental foramen. 0.1 × 0.2 cm shaped lateral cortical plate was removed around the mental foramen and incisal branch of neurovascular bundle was severed. After that, osteotomy was performed and bone segments were fixed with mini plates. Inter maxillary fixation continued for a week after operation. One year after operation, his occlusion is stable and sensory disturbance of lower lip is not recognized. We consider this method should be a candidate for patients with mandibular prognathism, who have normal occlusion in the molar region, although decompression of the neurovascular bundle is necessary to minimize damage to this structure.