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A prediction of postsurgical changes in the shape and position of the overlying soft tissue is an important part of orthognathic treatment planning. However, literature in soft tissue changes after mandibular setback in Egyptian adults is rare.The aim of this study was to cephalometrically evaluate the soft tissue profile changes after a mandibular setback procedure in Egyptian adult patients.This study included sixteen Egyptian adult patients, 8 males and 8 females, with mandibular prognathism who were subjected to mandibular setback surgery by bilateral sagital split ramus osteotomy (SSRO). The patients were subdivided according to sex in order to detect potential differences in the soft tissue response. Lateral cephalometric radiographs were taken presurgically, 6 months postsurgically to evaluate the changes from presurgery to postsurgery. The soft tissue profile changes after surgical setback of the mandible can be described as follows: Posterior movement of the mandibular incisor, point B, and pogonion was accompanied by posterior movement of 71% (male) and 82% (female) at labiale inferius; 88% (male) and 92% (female) at mentolabial sulcus; and 93% (male) and 103% (female) at soft tissue pogonion.After surgical setback of mandible, the ratios of soft to hard tissue changes are somewhat different between male and female, especially at labrale inferioris (Li) and soft tissue pogonion (PoG). The ratios of Li:li and PoG:Pog for male were smaller than for female. This suggests that the clinician should pay more attention to the depth of labiomental sulcus and new position of soft tissue pogonion when making surgical predictions for Egyptian adults with mandibular prognathism

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INTRODUCTION:Temporomandibular joint (TMJ) is a structurally complex joint. TMJ deficiency and deformity can result from different causes. Ankylosis of the TMJ is considered the most common cause leading to severe form of deformity and shortening of the ramus / condyle unit which can affect both, function and esthetic and is difficult to treat. Different surgical procedures have been used to treat this deficiency, with variable degrees of success rates. Distraction osteogenesis is a well-established technique that is used to treat different maxillofacial deformities. A recent use in reconstruction of the deficiency ramus-condyle unit is developed Aim: The objective of this study was to evaluate the use of transport distraction osteogenesis in restoring the deficient condyle/ramus unit of patients with unilateral or bilateral TMJ ankylosis to correct the resultant deformity. MATERIALS AND METHODS: Ten patients with TMJ ankylosis underwent Transport condylar ramus distraction osteogenesis to reconstruct the condyle after release and gap arthroplasty. The distractors used were extraoral submerged ones. Patients were randomly allocated into two groups. The first group transport condylar distraction was done immediately in the same operation after release of ankylosis. In the second group, distraction was done in a second stage. RESULTS: Our patients' age ranged from 2 to 46 years with an average of 18.2years. The follow-up period ranged from 15 to 60 months with an average of 30.2 months. Successful treatment was achieved in seven cases. Complications were mild in two, moderate in four and severe in three. CONCLUSIONS: Transport condylar distraction osteogenesis is a valuable treatment option for TMJ ankylosis. It has a considerable complication rate that must be considered and discussed thoroughly with the patient/guardian. Also, improvement of the design and handling characteristics of the distractors must be considered.