One-year stability of the mandibular advancement and counterclockwise rotation for correction of the skeletal class II malocclusion and high mandibular plane angle: Dental and skeletal aspect

Muhammad Ruslin, Andi Sitti Hajrah Yusuf, Tymour Forouzanfar, Rokus Barendregt Greebe, Dirk Bram Tuinzing, Sri Astuti Thamrin, Paolo Boffano, Lun-Jou Lo

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Background: The purpose of this study was to evaluate the stability on dental and skeletal aspect after surgical advancement and counterclockwise rotation for the correction of the mandibular deficiency in patients with high mandibular plane angle (MPA). Methods: We analyzed the records of patients who had undergone surgical treatment for dentofacial deformities with mandibular deficiency and high MPA. Clinical and radiological data were taken 1 month before surgery (T0), 6 weeks after surgery (T1) and 1 year after surgery (T2). Cephalometric values of the MPA were recorded and compared. The cephalometric changes in the different time periods were defined as follows: A: postsurgical changes (T0–T1), B: one-year changes (T1–T2), and C: short term changes (T0–T2). Results: Twenty-seven patients had prominent mandibular deficiency with an MPA of over 35° (high angle). The mean age of patients at surgery was 29.7 years. Seven patients had a single jaw procedure, 20 patients had bilateral sagittal split osteotomy (BSSO) combined with a Le Fort I osteotomy, and 14 patients had additional genioplasty. MPA values differed significantly between the time periods (p < 0.05) with an observed relapse of the angle. However, satisfactory clinical improvement was achieved in the dental and skeletal presentation. The overjet improvement was evident from 8.815 ± 2.085 mm (T0) to 3.426 ± 1.253 mm (T2). Conclusion: Counterclockwise surgical advancement of the mandible to correct mandibular deficiency in patients with a high mandibular plane angle showed an overall acceptable stability during one-year follow-up.

Original languageEnglish
Pages (from-to)206-214
Number of pages9
JournalBiomedical Journal
Issue number1
Early online date2022
Publication statusPublished - Feb 2022


  • Counterclockwise
  • Dental and skeletal
  • High mandibular plane angle
  • Mandibular deficiency

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