Evaluation of a Three-Stage Method for Improving Mandibular Retrognathia with Labially Inclined Incisors Using Genioplasty, Segmental Osteotomy, and Two-Jaw Surgery
Figure 3
Diagrams of the three-stage method. (a) Initial appearance is presented. (b) Advancement genioplasty (first surgery) is performed to construct a sufficient basal bone infrastructure for sequential periapical segmental alveolar osteotomy. (c) Thin cortical bone is harvested from the upper frontal edge of the genial segment, where the edges protrude by sliding the genial segment anteriorly. The thin cortical bone is positioned smoothly on the osseous gap created at the osteotomy line (arrowhead). Vacant space is made under the thin cortical bone (arrow). (d) New bone is augmented in the former osseous void area and a voluminous configuration with a smooth surface is created (arrow). (e) Periapical segmental alveolar osteotomy (second surgery, arrow) is performed to improve the axis of incisors. (f) The incisal segment is rotated while keeping sufficient bone contact at the stump. Finally, two-jaw surgery (third surgery) is performed to establish ideal occlusion.
