Mandibular sagittal subapical osteotomy: a case study.

A case involving mandibular sagittal subapical osteotomy has been demonstrated. When the patient presented initially I was unaware of this particular operation. Prior to surgical intervention there was significant improvement in the previously abused lower labial tissues, but an impasse developed with respect to limiting treatment to orthodontic means alone. Along with lower tissue recovery, unexpected benefits resulted, namely, bite opening, establishment of excellent occlusion, and dramatic facial improvement. Etiologically, it would appear that apparently a severe forward rotational growth pattern with muscular imbalance had produced an adverse facial configuration in an otherwise reasonable craniofacial complex. As a result of this experience, it was brought home more conclusively than ever that it is well to realize before entering into presumably minor or compromise treatment procedures for many orthodontic problems, particularly in advanced skeletal malocclusions, that the possibility of orthognathic surgery exists and one would be wise to explore thoroughly and advise those involved of such possibilities before becoming clinically involved.