Oral and maxillofacial surgery
Correction of square jaw with low angles using mandibular “V-line” ostectomy combined with outer cortex ostectomy

https://doi.org/10.1016/j.tripleo.2009.08.036Get rights and content

Objective

The objective of this study was to evaluate the feasibility and effectiveness of correction for square jaw with low angle using mandibular “V-line” ostectomy combined with outer cortex ostectomy.

Study design

From July 2005 to November 2007, 31 patients who had square faces with low angles were treated with mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy. All the patients had standard frontal and lateral cephalometric radiographs, panoramic radiographs, and were photographed preoperatively and postoperatively to assess their face contour. The alteration of mandibular angle and width of lower face was observed for 6 to 24 months postoperatively.

Results

Postoperative appearance of all 31 cases showed that the width of lower face was reduced expectedly; the gonial angle and the mandibular plane angle were increased effectively. The final aesthetic outcomes were quite satisfactory in all cases for both the surgeons and the patients.

Conclusion

A slender oval facial outline as the fashionable aesthetics could be achieved by using mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy. It might be a feasible and a reasonable surgical procedure for correction of square jaw with low angle.

Section snippets

Patients

From July 2005 to November 2007, there were a total of 31 patients in this study who received Mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy to correct the lower facial contour. The patients ranged from 20 to 31 years. Their chief complaint was square facial contour. Of these patients, 7 cases had asymmetric lower mandible margin and 15 cases had square chin.

Facial appearance characteristics: wide lower face in anterior view; gonial angle less than 120 degrees or

Results

The Mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy were performed successfully in all cases. No severe complications or unexpected fractures of the mandible body, ramus, or condyle were observed. Postoperative recovery was uneventful, and all wounds healed by primary intention without local infections.

In the 6- to approximately 24-month postoperative follow-up period, no facial paralysis or trismus was observed in any of the patients. Transient sensory disturbance

Case 1

A 26-year-old woman who had had a constant complaint about the shape of her wide lower face sought treatment for a square jaw.

Facial appearance characteristics: In anterior view, the lower face was wide and symmetrical, the gonial angle was 90 degrees, and lower mandibular plane angle was 0 degree in lateral view, with square chin but not too weak and buccal fat pad hypertrophy. In March 2006, the mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy and buccal fat pad

Discussion

A square face contour gives a strong, masculine, and unattractive impression, which generally is regarded as an aesthetic problem for women or even for some men in Oriental culture. Because of the fashion trends put forth by celebrities on television and in magazines, most Orientals would like to have a slender oval face shape. Not only those who have abnormal shape of their lower face, but also those who have normal ones are pursuing their face shapes to be just like some of the celebrities.

Conclusions

This study shows that a slender oval facial contour as in the fashionable aesthetics could be achieved by using mandibular “V-line” ostectomy combined with mandibular outer cortex ostectomy. It might be a feasible and a reasonable surgical procedure for correction of square jaw with low angles.

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This study was supported by Natural Science Foundation of China (30400506).

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