ABSTRACT
Osteotomy of the mandible can be used to address prognathic, retrognathic or asymmetric discrepancies. Mandibular procedures can be used in isolation or in combination with operations to the maxilla or chin. The key to all these procedures is a stable condyle–glenoid fossa relationship that must be maintained. The required anterior, posterior and transverse movements to achieve the desired postoperative occlusion are determined in the planning phase. This can be done with choosing the final planned occlusion on study models and carrying out model surgery with the wafer produced by hand, or alternatively the movements can be determined using digital planning. The role of virtual planning, 3D-printed cutting guides and pre-bent plates has been shown to reduce inaccuracies and some complications compared with conventional model surgery planning. In 1968, Winstanley performed the first intraoral vertical ramus osteotomy to manage horizontal mandibular excess, distal segment advancement of less than 2 mm, and rotation of the mandible.
