Vertical Ramus Osteotomy With Iliac Graft Versus Sagittal Split Osteotomy

Evaluating the Efficacy of Vertical Ramus Osteotomy With Iliac Graft Versus Bilateral Sagittal Split Osteotomy for the Correction of Mandibular Deficiency in Skeletal Class II Cases Management. A Randomized Controlled Trial

• Patients will be collected from faculty of dentistry
• bilateral vertical ramus osteotomy (VRO )with iliac graft group (group I):- 10 patients will be treated via VRO and iliac crest or
• bilateral sagital spilt osteotomy (BSSO) group (group II):- 10 patients will be treated via BSSO
• All patients will be studied by comprehensive clinical oral and maxillofacial examination and lateral cephalometric radiographic analyses, within 1 week before the surgery (T0), immediately after the surgery (T1), and 6 months after surgery (T2).
• All lateral cephalometric radiographs and clinical photographs must be standardized for all cases.
• After pre-surgical orthodontic treatment , a lateral cephalograph Will be obtained for planning the surgical movement of both jaws
• Surgical models and surgical stent will be fabricated.
• All surgical procedures will be performed under nasal intubation and general anesthesia to surgically reposition the maxilla in standard LeFort I setback fosteotomy; the BSSO group will be underwent BSSO, and VRO group will be underwent VRO
• The bony segments will be fixed in the new position with the use of custom made plates (specific for each patient )

Inclusion Criteria:

• patients with age above 18 years old suffered from skeletal class II with severe mandibular deficiency

Exclusion Criteria:

• patients with chin deviation,
• severe temporomandibular joint (TMJ) symptoms.
• Sever periodontal disease
• pregnancy,
• previous mandibular surgery,
• inability to follow-up for the study protocol