Facilitating ramus lengthening following mandibular-dependent surgical closing of a skeletal open bite with short ramus: a new modified technique.

Recent studies have shown that a sagittal split ramus osteotomy (SSRO) with counterclockwise rotation of the mandible using rigid fixation is relatively a stable procedure when used to correct a mild skeletal anterior open bite in cases where a maxillary osteotomy is not indicated to improve or enhance facial aesthetics. When an open bite accompanies a short ramus, the closing rotation will result is a large amount of ramus lengthening and downward movement that stretches the major muscle-ligament structures attached to the ramus, with a risk of relapse. In order to overcome this problem we have adopted a modified surgical technique in which a considerable amount of ramus lengthening following mandibular rotating can be achieved. In this paper, the technique will be introduced and illustrated. Advantages and disadvantages will be also discussed.