Orthognathic surgery in “older” adults with Hemi-Mandibular Elongation: Long-term occlusion outcomes

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Purpose: The purpose of this study was to describe a consecutive series of subjects with HME who underwent orthognathic correction after 26 years of age. The investigators hypothesized that for this group of HME subjects, bimaxillary orthognathic correction would result in a favorable initial and long-term occlusion. Materials and methods: A retrospective cohort study was implemented. The sample included a consecutive series of HME subjects >26 years of age undergoing bimaxillary osteotomies. The outcome variables were the achievement and maintenance of a corrected occlusion after surgery. We compared the occlusion at intervals before surgery (T 1 ), 5 weeks postoperatively (T 2 ), >2 years after surgery (T 3 ). Descriptive and bivariate statistics were calculated. P < 0.05 was considered significant. Results: 13 subjects met inclusion criteria with a mean age of 36 years. All subjects underwent maxillary advancement. All subjects underwent mandibular surgery with 92% receiving advancement. Sixty-nine percent of subjects had a maxillary occlusal cant. In 12 of 13 subjects, a favorable occlusion was maintained long-term (T 3 ) after surgery. Conclusion: We confirmed that bimaxillary orthognathic surgery in HME subjects >26 years of age results in a favorable initial occlusion which is maintained long-term. These findings are similar to that previously reported in HME subjects <26 years of age.

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