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Purpose <p>This study aims to report a clinical case involving a patient with dentoskeletal discrepancy and mandibular transverse arch excess, treated with orthognathic surgery combined with mandibular midline osteotomy. A 20-year clinical follow-up was conducted to evaluate the long-term stability and predictability of the surgical approach.</p> Case Report <p>A 26-year-old female patient with skeletal Class III malocclusion and bilateral posterior crossbite underwent maxillary advancement, mandibular setback, midline mandibular osteotomy, and genioplasty. A hybrid fixation technique was employed using bicortical screws and titanium plates. The patient was monitored over a 20-year period.</p> Results <p>The patient demonstrated good postoperative recovery and long-term stability in both occlusion and facial symmetry. No significant complications were observed during the follow-up period, and the surgical correction remained stable over two decades. </p> Conclusion <p>Mandibular midline osteotomy, when properly indicated and combined with sagittal split osteotomy, is a reliable and effective technique for correcting transverse mandibular excess. The case reinforces the long-term stability and functional-aesthetic success of this surgical approach.</p>

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Mandibular Midline Osteotomy as an Alternative for the Treatment of Mandibular Arch Transverse Excess: Case Report (20-Year Follow-up)

  • 期刊论文

  • 发表日期：

    2025年8月22日

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  • Raphael De Marco,
  • Adriano Lia Mondelli,
  • João Guilherme Zanutto Martins,
  • Letícia Liana Chihara,
  • Osny Ferreira Júnior,
  • Eduardo Sant’Ana

摘要

Purpose

This study aims to report a clinical case involving a patient with dentoskeletal discrepancy and mandibular transverse arch excess, treated with orthognathic surgery combined with mandibular midline osteotomy. A 20-year clinical follow-up was conducted to evaluate the long-term stability and predictability of the surgical approach.

Case Report

A 26-year-old female patient with skeletal Class III malocclusion and bilateral posterior crossbite underwent maxillary advancement, mandibular setback, midline mandibular osteotomy, and genioplasty. A hybrid fixation technique was employed using bicortical screws and titanium plates. The patient was monitored over a 20-year period.

Results

The patient demonstrated good postoperative recovery and long-term stability in both occlusion and facial symmetry. No significant complications were observed during the follow-up period, and the surgical correction remained stable over two decades.

Conclusion

Mandibular midline osteotomy, when properly indicated and combined with sagittal split osteotomy, is a reliable and effective technique for correcting transverse mandibular excess. The case reinforces the long-term stability and functional-aesthetic success of this surgical approach.