Pitfalls and Management of Mandible Angle Reduction

Lee, Sung Su; Lee, Won Jai; Park, Beyoung Yun

Abstract

In general, orientals have a round and broad facial contour. In case of females with prominent mandible angles, the facial contour may look very square-like and unnatural with a masculine image. Recently, due to western aesthetic standards, there tends to be an increase of mandible angle reductions for an oval shaped face. The two methods for mandible angle reduction are curved horizontal ostectomy and angle splitting ostectomy depending on the layer of bone excision. The curved horizontal method may improve the lateral view of the patient but limited improvement is shown on the frontal view due to the lack of reduction of the mandible bone width. The angle splitting ostectomy improves the frontal view by decreasing the mandible bone width but there is limited change on the lateral view due to minimal change of the mandible angle contour. Currently, there are no specific protocols to determine the ideal operation methods for patients with prominent mandible angles. The authors measured the degree of mandible angles of 35 patients with prominent mandible angles and divided them into 3 types; severe <105, moderate 105 - 125, mild > 125. Patients with severe type angles showed best results with both operations combined due to not just the prominence of the angle but the width of the mandible bone. Patients with mild type angles obtained satisfactory results only with angle splitting ostectomy because they could have a natural lateral view. In case of moderate type angles, patients with angles closer to 105 should undergo curved horizontal ostectomy and those with angles closer to 125 should be operated with angle splitting ostectomy for satisfactory results.