The combination of the mandibular Köle procedure and bilateral sagittal splitting in orthognathic surgery has positive effect in esthetics and function for short-throat-length skeletal class III patient

Correcting protruding maxillary appearance through one-piece Le fort I osteotomy without premolar extraction

“…For patients with bimaxillary protrusion and minimal maxillary vertical excess, combining maxillary subapical osteotomy with mandibular Kole procedures has been suggested in the literature. 1 , 5 In addition to the treatment in the present case report, solitary one-piece Le fort I osteotomy setback may be performed under several other conditions: (1) when the setback distance is too short to extract the premolars, (2) when the space of the extraction sites has already been used to relieve dental crowding, (3) when there is no candidate for extraction because of congenital missing teeth or previous orthodontic treatment performed at early age, or (4) when demanded by the patient or orthodontic doctor. Furthermore, one-piece maxillary setback has many advantages, including (1) improvement in dentition; (2) treatment time reduction; (3) no risk of compromising the vascular supply of the anterior maxillary segment or bone necrosis; and (4) no risk of the complications of segmental osteotomy, which include unpredicted bone splitting, nonunion or malunion, oro-antral fistula, periodontal damage, and damage to the adjacent teeth.…”