The Standard Mandible Reduction with Intraoral Approach
For precise surgical planning and prevention of postoperative asymmetry, three-dimensional analysis of the photographs and the radiographs in the frontal, sagittal, and transverse planes is important.
The inferior alveolar nerve is the most important structure during mandible reduction, and it should be carefully examined preoperatively in panoramic view as well as in a computed tomography (CT) scan.
The superior limit for resection is the occlusal plane; the anterior limit is the convergence of the mandibular oblique line with the lower mandibular border and mental nerve.
The resected segment typically has an elongated semilunar shape instead of being triangular; when removed, it leaves a gently curved lower mandibular border.
If an osteotomy is too straight and fails to form a smooth transition, it will leave a “secondary angle.” The secondary angle can be palpated or sticks out externally. If secondary angle is obvious, it may require burring or additional osteotomy.
In cases of an inward-curled angle with a convex transverse shape, sagittal resection of the body is required to reduce the width of the mandible more effectively.
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