Abstract
The standard surgical treatment for mandibular prognathism is sagittal split ramus osteotomy (SSRO) if the proximal and distal segments of the ramus require fixing with screws or metal plates. In this procedure, however, it is frequently difficult to avoid neurosensory disturbance (NSD) of the inferior alveolar nerve (IAN) when the posterior margin of the ramus curves inward or when the ramus is thin (Fig 1A,B).
Highlights
The standard surgical treatment for mandibular prognathism is sagittal split ramus osteotomy (SSRO) if the proximal and distal segments of the ramus require fixing with screws or metal plates
The osteotomy plane is between the mandibular canal and the lateral cortical plate of the ramus as in SSRO, damage to the inferior alveolar nerve (IAN) can be avoided because the osteotomy is performed from a point in front of the foramen between the mandibular canal and the immediately medial lateral cortical bone.[1, 2] making it possible to strip the lateral cortical bone from the bone marrow
It is easy to check the position of the distal segment after osteotomy because the anterior area of the proximal segment is removed beforehand; the subcoronoid area of the distal segment and the subcondylar area of the proximal segment can be used for insertion of screws
Summary
The standard surgical treatment for mandibular prognathism is sagittal split ramus osteotomy (SSRO) if the proximal and distal segments of the ramus require fixing with screws or metal plates. One of the main advantages of IVSRO is that it avoids IAN damage, because the ramus can be split parallel to the original sagittal plane posterior to the point between the mandibular canal and the lateral cortical bone plate immediately in front of the antilingular prominence. In this method the anterior border of the proximal segment is partially removed at the beginning of the osteotomy procedure as described by Kitajima et al in 1989. This chapter introduces this procedure and the technique of rigid fixation of IVSRO for treatment of mandibular prognathism
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