Correction of mandibular deficiency by inverted-L osteotomy of ramus and iliac crest bone grafting

Abstract

This study was to describe the use of inverted-L osteotomy of ramus and iliac bone graft for the management of mandibular deficiency in adult patients. From 2008 to 2010, 11 patients (aged 19 to 29 years) with mandibular deficiency underwent intraoral or extraoral inverted-L osteotomy of ramus and iliac crest bone grafting. Data were collected from the patients’ records, photographs and radiographs. The height and width of the ramus were successfully expanded by inverted-L osteotomy and iliac crest bone grafting with minimal complications in all patients, resulting in significant improvement in occlusion and facial appearance. Our early results showed that the inverted-L osteotomy of ramus and iliac crest bone grafting is safe and effective, and should be considered as a good alternative for the patients with mandibular deficiency. Clinicians in China report that an alternative surgical procedure to correct retrusion of the lower jaw is safe and effective. Backward displacement of the lower jaw, or mandibular deficiency, can affect an individual’s facial appearance and the ability to chew food, speak, breathe, and sleep normally. Bilateral sagittal split ramus osteotomy (SSRO), the procedure typically used to correct mandibular deficiency, has associated risks of nerve injury and relapse. Jing Hu and his colleagues at Sichuan University, China, therefore assessed the clinical efficacy of the less-established, alternative procedure known as inverted L-osteotomy (ILO). Their early results showed that ILO aligned the upper and lower jaws of 11 adults with mandibular deficiency. The patients’ aesthetic appearances improved, and they had no associated permanent damage to their facial nerves.