Anterior oblique osteotomy for mandibular advancements: highlighting a minimally invasive solution.

Abstract

Objective: Bilateral sagittal split osteotomy (BSSO) is widely used for mandibular advancements but is often associated with complications such as nerve disturbances, limited angle projection, and mandibular notching. This study describes a modification, the anterior oblique osteotomy (AOO), within the minimally invasive orthognathic surgery (MIOS) concept, addressing these challenges.

Methods: A single-center retrospective study was conducted involving 30 patients who underwent bimaxillary surgery using AOO. Pre- and postoperative computed tomography scans were analyzed to measure the increase in posterior mandibular height.

Results: The mean mandibular advancement was 7.8 mm, with no unfavorable splits or nerve injuries. All patients achieved full recovery of the inferior alveolar nerve by two weeks postoperatively. Significant improvements in posterior mandibular height were observed, increasing from 58.3 mm preoperatively to 67.2 mm postoperatively (p < 0.001). No cases of non-union, malunion, malocclusion, or relapse were reported during follow-up.

Conclusions: The AOO technique, when applied within the MIOS framework, presents a viable alternative to traditional BSSO, it offers reduced morbidity and enhanced aesthetic results. Further studies, including control groups, are recommended to confirm the long-term stability of the vertical increase and clinical outcomes.