Orthodontic-Orthognathic Management of a Patient With Severe Mandibular Deficiency Due to Bicondylar Fracture: A Case Report

Abstract

This case report is about a 30-year-old Iranian female. The patient’s chief complaint was the backwardness of the lower jaw. The patient reported a history of condylar fractures in childhood. There was crowding in the maxillary and mandibular arch, and the midline in the mandible was 2 mm deviated to the left. The canine and first premolar on the left side of the maxilla were extracted, and the canine on the left side of the mandible was impacted. Clinical examinations and paraclinical documents revealed that the patient was a skeletal class II case with mandibular deficiency, complicated by a vertical maxillary excess. Virtual surgery planning was used to plan the patient’s treatment. The amount of adhesion of soft tissue to hard tissue was also taken into consideration. According to the measurements of the patient and the class II, vertical maxillary excess of the patient, the shortness of the ramus, and the large angle of the occlusal plane, our chosen orthognathic surgery included bilateral sagittal split osteotomy, advancement genioplasty, and maxillary impaction.

Keywords: Orthognathic surgery, Mandibular advancement, Mandibular condyle