Management of Class II Hyper Divergent Mandible by Surgically Altering Occlusal Plane Pattern Through Counterclockwise Rotation of Mandible

Abstract

ABSTRACT newlineAIM: To evaluate the facial aesthetic of the Class II hyperdivergent mandible, by altering the high Mandibular plane angle into an orthognathic mandibular plane angle by counterclockwise (CCW) rotation of the mandible. newlineMATERIALS AND METHOD: 20 patients aged between 19 to 26 were selected for this study. These patients were divided into Group I (control group) - and Group- II (test group), each comprising 10 patients. In Group I (control group) patients were surgically operated on for Vertical maxillary impaction and Conventional Mandibular advancement of skeletal class II patients (Bi-jaw surgery). In Group II (test group) they were operated by Modified Counter-clockwise Mandibular advancement with a posterior open bite of 4mm for skeletal class II patients (Single jaw surgery).11 linear and 11 angular measurements were taken. Pre- and post-surgical values were evaluated by composite cephalometric analysis and the changes in the occlusal plane and facial height were statistically analyzed by using paired t-tests. Jarabak s ratio is also calculated for facial height. Further finishing will be done by postsurgical orthodontic procedures to get functional occlusion. newlineRESULTS: Change in occlusion to class I is seen in values of Jarabak ratio and Go-Gn. Jarabak ratio shows an increase in posterior and a decrease in anterior facial height. Go-Gn implies the CCW movement of the mandible has reduced anterior open bite and created a posterior open bite of 4mm for the supra-eruption of teeth. newlineCONCLUSION: BSSO with CCW rotation of the mandible with a posterior open bite of 4mm using a bite block, is conservatively involved in single jaw surgery, thereby improving the facial aesthetics of the patients. newlineCLINICAL SIGNIFICANCE: This innovative method of CCW rotation of the mandible with open bite mainly prevents the bi-jaw surgery, improves stability, and gives an aesthetically good appearance. newline newline