Rigid fixation of the intraoral inverted 'L' osteotomy.

Several articles have been written on the use of intraoral vertical subcondylar or inverted “L” osteotomies. le4 Although these procedures have been popular with surgeons to set the mandible back, a disadvantage is the necessary use of maxillomandibular fixation for 6 to 12 weeks. Paulus and Steinhauser’ have described lag screw fixation of vertical subcondylar osteotomies. However, they noted the difficulty in placing more than two screws. Kraut6 discussed placing “T” plates on vertical subcondylar osteotomies. This was followed by maxillomandibular fixation for 1 to 5 days postoperatively. Generally the reasons why rigid fixation has not been popular for vertical subcondylar osteotomies are the inability to position the condylar segment and difficulty controlling the segments. The purpose of this report is to describe a technique used by the authors for the last year to treat mandibular setbacks by an inverted L osteotomy and rigid fixation.