Enhancing facial aesthetics: Vertical ramus osteotomies for mandibular disproportions

Abstract

Introduction

Orthognathic surgery has evolved significantly. While sagittal split ramus osteotomies with rigid fixation are now the preferred technique, vertical ramus osteotomies remain beneficial in specific cases. This report details three cases where virtual surgical planning achieved excellent outcomes with vertical ramus osteotomies.

Case series presentation

This case series presents three patients with severe mandibular prognathism and facial asymmetry. All patients were treated using a combined approach of Le Fort I osteotomy and intraoral vertical ramus osteotomies, guided by virtual surgical planning. Long-term occlusal stability and aesthetic improvements were achieved at the 1- and 1.5-year follow-up.

Discussion

The selection of the surgical technique for mandibular osteotomies is a crucial aspect of orthognathic treatment planning. While the sagittal split ramus osteotomy has become the workhorse procedure in many centers, the vertical ramus osteotomy presents a distinct set of benefits that justify its consideration in carefully selected cases.

Conclusion

Vertical ramus osteotomy remains a valuable surgical option for patients with severe prognathism and significant mandibular asymmetries. The presented cases demonstrate the potential for excellent clinical outcomes with this technique, suggesting its value in the orthognathic surgeon's armamentarium.