For the correction of mandibular deformities, we use frequently sagittal splitting ramus osteotomy. However, in patients who have good occlussion in the molar region, mandibular body ostectomy should be considered for such cases.
To overcome some of disadvantages that mandibular body ostectomy has less bony contact between proximal and distal segments, and difficulty adjusting each segment, we improved this method by preserving lingual cortex via an intraoral approach.
After separation of the buccal cortex with a fine osteotome, the lingual cortical bone is preserved by only distal or mesial single vertical osteotomy with a reciprocating saw. This osteotomy at the lingual cortex is carefully done following model surgery and cephalometric prediction.
This technique could be used in cases in which good occlusion cannot be obtained by sagittal splitting ramus osteotomy.

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The mandibular body osteotomy operation has become unpopular recently with the development of the mandibular ramus osteotomy. However, there were several cases which seemed to be an indication of this operation.
In this paper, a successful surgical-orthodontic case with the mandibular body osteotomy was reported and its associated problems were discussed.
A twenty year and five month old man showed mandibular prognathism with anterior open bite due to a large and clockwise rotated mandibular body. The body osteotomy was performed in the space of the first molar extraction. The mandibular arch width was adjusted in pre-surgical orthodontic treatment by the lingual arch appliance. It took two years and three months for the total active treatment and one year for retention. The treatment was finished successfully and followed up for eight months after retention.
Through this case, we reconfirmed the usefulness of the body osteotomy in the case of mandibular prognathism with the poor molar condition. By careful maintenance of the excision space, prevention of injurying adjacent teeth and the neurovascular bundle and also comprehensive periodontal care after surgery, we had a stable result with the mandibular body osteotomy.

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Broad soft-tissue pedicle genioplasties were performed in 6 patients by horizontal osteotomy of the inferior border of the mandible, with preservation of a musculoperiosteal pedicle to the genial segment. Preoperative, immediate postoperative, and long-term follow-up lateral cephalometric radiographs were retrospectively analyzed to evaluate the osseous and soft-tissue changes of the chin. After a mean follow-up period of 29 months, all cases preserved the initial advancement. No case showed bone resorption from pogonion to the menton region.
The chins advanced by broad soft-tissue pedicle genioplasty had good stability.

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The relation between Ricketts' facial patterns and the spine condition in preoperative mandibular prognathism patients was examined in this report.
1. Anomaly of the rib hump angles was found most often in the Brachyofacial pattern.
2. Anomaly of the rib hump depressions was often found in the Brachyofacial pattern.
3. There was no difference of the rib hump form among the three groups. But with the Brachyofacial pattern there were many Group 3 rib hump forms.
4. Anomaly of the spine curvature in the lateral view was found most often in the Brachyofacial pattern and to a less extent in the Dolicofacial pattern.
It is concluded that anomaly of the spine was found to a high degree in the Brachyofacial pattern in preoperative mandibular prognathism patients.

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The changes of psychological aspects, particularly their chief complaints, in patients with surgical orthodontics, were studied by using a questionnaire by patients' self-evaluations.
The subjects were 53 patients (14 males and 39 females) out of 205 patients who underwent surgical orthodontics for ten years (1978-1987). The questions consisted of 43 items which included motive for treatment, facial profile, dentition, function, oral hygiene, and psychological aspects. On the basis of results in their answers about cheif complaints, the subject was divided into three groups, namely the dentition-, profile-, and function-groups.
The following results were obtained.
1. Chief complaint was dentition in 53% of all subjects, facial profile in 26% and dysfunction of mastication in 8%.
2. The profile-group was more dissatisfied with their facial profile before treatment than the dentition-and function-groups. They were less satisfied with their facial profile after treatment than the other groups.
3. The dentition-group was more dissatisfied with their dentition before treatment than the profileand function-groups. They were more satisfied with their dentition after treatment than the other groups.
4. On the mastication, there was a significant relationship between the degree of dissatisfaction before treatment and the degree of satisfaction after treatment.
5. There was a significant relationship between the degree of satisfaction with their facial profile after treatment and their change of extroversion.
6. 94% of the subjects felt that it was good that they had undergone surgical orthodontics. On the other hand, 26% of the subjects didn't want to undergo surgical orthodontics, if they had experienced information for this treatment. It was suggested that most of the patients were burdened by surgical orthodontics.

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Recently orthognathic surgery, to cope with jaw deformity, has become popular, and has been performed by many oral surgeons.
As a result of the progress of surgical techniques, it has been possible to treat a patient with severe jaw deformity with an excellent postoperative profile. But the cause of this disease has still not been discovered. We performed the following study to investigate the cause of jaw deformity. Sixteen patients who had facial asymmetry to transform their deformed jaws were the object of this study. The patients were divided into two groups. Group I-patients who had mid and lower face asymmetry and Group II-patients who had lower face asymmetry.
In our study, using computerized tomography, we found the following result, In 100% of Group I patients and 50% of Group II patients, the malposition of the chin was opposite the deformation from the temporal region to the occipital region. In other words the chin shifts in the opposite direction of the abnormal shape of the head, of person with jaw deformity.

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In sagittal split ramus osteotomy, positioning and fixation of external fragments influences on relapse or temporo-mandibular-joint (TMJ) function. We take a line to keep preoperative TMJ positions, if we observe no sign of TMJ clinically and roentogenographically. Then we established external fragment repositioning system making use of “Würzburg sagittal split system” and ready-made facebow and double buccal tubes for orthodontic treatments. This system requires no special instruments, materials and complex laboworks, do not elongates operation time too much to interfere the manipulations, and realizes sure and exact reposition of external fragment. From July 1990 to November 1991, we applied this system to 26 cases of mandibular prognathism or skeletal open bite, and obtained good clinical results.

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The sagittal split osteotomy of the mandible is widely used for the correction of various dentofacial deformities in Japan but was some problems to apply it to Japanese women whose mandibular ramus are small and thin.
From these reasons, we developed a modified technique of the procedure that the mandibular ramus was cut by a reciprocating bone saw with minimal split, and osteotomized segments were fixed monocortically with titanium miniplate and screws placed by Angular screwing instrument^® on each side without skin incision.
Based on our experience of 30 cases treated by the procedure from September 1989 to December 1990, following merits are obtained.
1) Bone cut is safer and easier and cutting surfaces become flat and smooth because of minimal split.
2) Placement of miniplate and screws is made easily by Angular screwing instrument^® without skin incision.
3) A sharp angle at the second molar region made by bone cuttings allows the sufficient rigidity of the monocortical fixation between segments by one miniplate and screws.
6) Postoperative adaatation to the new occlusion is rapid because the duration of the maxillo-mandibular fixation decreases significantly.

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The treatment of skeletal anterior open bite deformity using the single-stage maxillary posterior segmental osteotomy has been followed for 5 years to evaluate the final outcome of the operation. The clinical and radiographic examination during the control period show a remarkable stable result without a relapse. Treatment planning based on clinical, ceahalometric, dental plaster model examination and tongue posture analysis allows the accurate and predictable correction of this deformity. In addition, tongue posture had shifted from anteriorly and superiorly to posteriorly and inferiorly after surgery. The stable occlusion and this improvement of tongue posture after maxillary posteriorly segmental osteotomy is an effective surgical procedure for the skeletal open bite.

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A case of mandibular prognathism with Marfan's syndrome treated with sagittal splitting ramus osteotomy was presented.
A 37 year-old man, complaining of difficulty of mouth opening was referred to our clinic. The patient was diagnosed as bilateral temporomandibular joints arthrosis with mandibular prognathism.
Although occlusal treatment with bite splint was effective to some extent, intermittent trismus did not disappear, so bilateral sagittal splitting ramus osteotomy was performed to correct his dental malocclusion.
Postoperative course was not eventful and his range of mouth opening increased to 35mm between incisal edges of maxillary and mandibular central incisor.

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