Treatment of Nonunion in the Mandible After Orthognathic Surgery to Correct Transverse Asymmetry of the Face

Abstract

Purpose: The present study aims to report the reoperation of an unsuccessful orthognathic surgery with the use of heterogeneous graft and hybrid rigid internal fixation. Case Report: We report the case of V.M.S., a 19-year-old female patient with the main complaint of “crooked chin.” The patient revealed that she previously underwent two operations that were conducted by a different team. The first surgery was carried out to correct the dentofacial deformity, while the second one was intended to eliminate a postoperative infection. After a detailed anamnesis, facial analysis, cephalometric analysis with tomography, and examination of gypsum models, we observed mandibular left-handedness and vertical maxillary excess on the right side. In addition to these previously reported problems, there was a nonunion in the region of the sagittal fracture of the left jaw. Results: The patient underwent surgery to correct dentofacial deformity using the Le Fort I maxillary osteotomy technique and bilateral sagittal osteotomy with hybrid rigid internal fixation plus mentoplasty. Conclusion: Six months following the procedure and orthodontic completion, the patient has a satisfactory occlusion and stability of nonunion without the laterognathism in the skeletal and soft tissue profile.