Lower jaw osteotomy (sagittal split osteotomy)

A lower jaw (the mandible) that is set too far back gives a receding chin, with the lower teeth sitting well behind the upper ones; a mandible that is too far forward gives a prominent chin, with the lower teeth in front of the upper ones. A mandibular osteotomy moves the lower jaw into the correct position. The most widely used technique is the bilateral sagittal split osteotomy. It is performed under general anaesthesia, through incisions inside the mouth, behind the last molars: no scar is visible. The bone is cut on each side, the tooth-bearing part is moved forward or back according to the plan, then secured with small titanium plates or screws. It is usually part of a treatment combining an orthodontist and a maxillofacial surgeon. It may be performed alone or together with an upper jaw osteotomy, and is sometimes completed by a genioplasty (repositioning of the chin). At Clinique Pasteur Tunis, this surgery is performed by maxillofacial surgeons in the operating theatre, in coordination with the patient's orthodontist, with suitable monitoring after the operation.