OGS management in Bimaxillary Skeletal Protrusion
Surgical Approaches for Bimaxillary Skeletal Protrusion
Clement CH Lin
Bimaxillary protrusion is one of the common presentations that a patient with Class II malocclusion may have.
Conventional goals of orthognathic-orthodontic treatment in Class II dentofacial deformities are aiming for ideal occlusion and pleasing facial profiles. Clinical examination, dental evaluation and cephalometric studies, 2D or 3D, may provide detailed information for correction of compound dentoskeletal anomalies.
Since the awareness of the correlation between retrognathia and obstructive sleep apnea, the upper airway evaluation became fundamental before the treatment plan decision for patient with Class II deformity. When indicated, a polysomnography should be performed before surgery. A complete upper airway evaluation can help to avoid possible complications of sleep-related disordered breathing, obstructive sleep apnea or perioperative compromise of the airway.
Comprehensive considerations in orthognathic-orthodontic treatment for Class II dentofacial deformity should take care of the aesthetic requirements by the patient, a perfect dentoskeletal relationship, and a patent airway. Common surgical techniques demanded are LeFort I with/without anterior segmental osteotomy, bilateral sagittal splits with/without anterior segmental osteotomy, and genioplasty.