Short lingual osteotomy without fixation: a new strategy for mandibular osteotomy known as “physiological positioning”

Abstract

This article advocates the physiological positioning strategy (PPS) as a novel alternative treatment strategy to conventional orthognathic surgeries. Eighteen patients with skeletal mandibular prognathism were treated with surgery using the PPS. SNB and FMA as well as the Me position were measured after surgery to determine the skeletal stability, and the changes in the angle and perpendicular length of the upper and lower central incisors were also calculated after surgery to determine the dental stability.Excellent skeletal and dental stabilities were confirmed. The width of the jaw opening recovered early, and one temporomandibular joint disorder case was observed. Short lingual osteotomy with the PPS represents an effective new treatment approach for mandibular jaw deformities.

The skeletal stability after maxillo-mandibular osteotomy with a “physiological positioning strategy”

“…Subsequently, a short lingual osteotomy of the mandible was done as reported previously. 10,12 Simply, the lingual osteotomy was extended further anteriorly from the posterior border of the ramus. All the masseter muscles, medial pterygoid muscles, and stylomandibular ligaments were left intact.…”

“…1). 10 Briefly, jaw exercise was initiated on the second postoperative day with a splint and elastic bands. After the 6th week the exercises were continued without a splint.…”

“…Exercise of the jaw with elastic bands is initiated on the second postoperative day, as described previously. 10,11 After this, postoperative stability of the mandible is obtained with short lingual osteotomy without of between the bony segments. 10 With physiological positioning, exercise of the jaw is initiated on the second postoperative day.…”

“…10,11 After this, postoperative stability of the mandible is obtained with short lingual osteotomy without of between the bony segments. 10 With physiological positioning, exercise of the jaw is initiated on the second postoperative day. There was concern that this early initiation of exercise might affect maxillary stability after maxillomandibular osteotomy because of the short duration of maxillomandibular fixation, and because of the thrust and traction forces induced by the exercise of the jaw with elastics.…”

“…8,9 To avoid these complications, we advocate a new strategy for mandibular osteotomy, physiological positioning . 10 Briefly, a short lingual osteotomy, a modified SSRO, is used for the mandible, and the segments of bone are not fixed. Exercise of the jaw with elastic bands is initiated on the second postoperative day, as described previously.…”