In adult patients with both maxillary transverse deficiency and
retrusion, the general treatment approach is primarily to perform surgically assisted rapid maxillary expansion (SARME) to correct the transversal problem and then to perform Le Fort I osteotomy to address the anteroposterior deficiency.
It causes
retrusion of middle portion of thyroid cartilage leading to reduction in vocal cords length9.
The main goal of treatment for skeletal Class II in growing patients is to obtain "lengthening" of the mandible.1 Skeletal Class II malocclusion can result from either maxillary protrusion, mandibular
retrusion, or a combination of the two.2 Treatment plan of these patients should be directed towards to solve the dentoskeletal disharmony in order to obtain favorable facial aesthetics.3
(2017), in a study of subjects with a class III facial deformity who underwent orthognathic surgery, found that a greater mandibular
retrusion in the postoperative stage is associated with a greater nasolabial angle.
Bone deformities were characterized as mandibular
retrusion, mandibular ramus shortening, anterior open bite, micrognathia and microgenia.
This type of malocclusion is often associated with mandibular skeletal
retrusion. Therefore, the main goal of the skeletal Class II treatment protocol is to modify and direct mandibular growth (2).
###3###Major###septum is responsible for columellar
retrusion. Tip projection is decreased and the
Examination was remarkable for facial dysmorphisms (prominent eyebrows, low set ears, midfacial
retrusion, and mild prognathism) (see Figure 1) and a genital exam that showed a micropenis.
Moderate or severe mandibular
retrusion cases, however, are commonly treated with bilateral mandibular ramus sagittal split osteotomy (BSSO).