Orthognathic Surgery for Mandible

Abstract

Mandible, a horseshoe shaped bone of the facial skeleton, is one of the sturdy bones in humans. Prominent chin is a unique feature of anatomically modern man in comparison with his anthropological ancestors. The simian shelf has reduced to two genial tubercles to which two muscles are attached. The neck of the condyle has narrowed and acts as a buffer to budge by fracture if there is a severe force on the prominent chin. These evolutionary changes facilitated increased space for the tongue as men started articulation. It articulates with the temporal bone by two inter-dependent Temporo-mandibular joints. Mandible is important in both function and aesthetics.Mandible can be cut into multiple pieces and re-arranged and fixed to achieve aesthetic and functional changes. Facial bones have a tremendous capacity to regenerate and heal provided proper blood supply is ensured to the cut segments. Ostoetomies of the mandible can be done on ramus, body, chin, dento-alveolar region, inferior border, etc. Most of these procedures are done intraorally. Technological advancements have aided orthognathic surgery at large. This chapter envisages to elaborate different techniques of osteotomy of mandible.

Mandibular midline osteotomy for correction of bimaxillary transverse discrepancy: a technical note

“…It has been noticed that midline widening is more difficult than narrowing mainly due to tissue resistance. Therefore, rigid fixation may be necessary in the anterior mandible to prevent torquing movement of the bony segments by muscle pull 20 . It was recommended to use rigid fixation using bi-cortical screws or rigid osteosynthesis for some mandibular widening cases due to potential instability, however, it was not required in our study.…”