Case Report Seven Years of Retention of Severe Mandibular Prognathism Treated With Bimaxillary Surgery: Two Case Reports Tu ¨ lin Ufuk Toygar-Memikog ˘ lu; 1 Halise Aydemir; 2,* Hakan Alpay Karasu; 3 and Nejat Bora Sayan 4 ABSTRACT These case reports describe the surgical treatment of 2 male adult patients with severe mandibular prognathism. For both patients, anterior repositioning of the maxilla by Le Fort I osteotomies with and without impaction and mandibular posterior repositioning by sagittal split ramus osteotomies were performed. The aim of this case report is to identify successfully treated surgical cases maintaining the results throughout the follow-up period of 7 years. KEY WORDS: Surgery, Prognathism, Retention INTRODUCTION Correction of facial deformities with orthognathic surgery has been the solution for many people who are not pleased with their facial appearance. For over 30 years, orthognathic surgery has proved to be a significant tool in correcting severe dentofacial defor- mities. Although numerous articles have been report- ed on the surgical procedures of various dentofacial deformities, it is still a challenge to plan and perform orthognathic surgery for severe mandibular progna- thism. Not only esthetic and functional rehabilitations but also stability after orthognathic surgery should be seriously considered in the treatment plan. The objective of this article is to report 7 years of retention records of 2 severe dentofacial deformity cases treated with Le Fort I and sagittal split ramus osteotomies. REPORT OF 2 CASES Diagnosis and Treatment Planning Two patients with no contributory medical history were referred for the correction of their skeletal deformity. The patients had protruded mandibles with no facial asymmetry. They had proper lip incompetence in the rest position. They did not have any symptoms of temporomandibular joint dysfunc- tion. Patient 1 was a 19-year-old man complaining about his prominent chin and difficulty in chewing and articulation. He had 4.5 mm of negative overjet and 7 mm of negative overbite (Fig. 1). He had Angle Class III molar and canine relationship. He had his left upper second premolar and first molar extracted. Cephalometric analysis confirmed that the mandible protruded 10 mm according to the cranial base and showed posterior rotation, moderately increasing facial height. The patient’s treatment was initiated after the extraction of the lower left and upper right third molars and the infectious lower right first molar. The other third molars were preserved to close the extraction spaces in the dental arches. After the leveling phase and closing the extraction spaces for 1 Professor, University of Ankara, Faculty of Dentistry, Department of Orthodontics, Ankara, Turkey 2 Assistant Professor, Orthodontist, Turgut O ¨ zal University Oral and Dental Health Care Center, Ankara, Turkey 3 Professor, University of Ankara, Faculty of Dentistry, Department of Maxillofacial Surgery, Ankara, Turkey 4 Professor, University of Ankara, Faculty of Dentistry, Department of Maxillofacial Surgery, Ankara, Turkey *Corresponding author: Halise Aydemir, DDS, PhD, Alparslan Tu ¨ rkes x caddesi no: 57, Emek, Ankara, Turkey. Tel: þ90-312-203 5352; þ90-530-155 0952 E-mail: hsbolatoglu@ yahoo.com To cite this article: Toygar-Memikog ˘lu TU, Aydemir H, Karasu HA, Sayan NB. Seven years of retention of severe mandibular prognathism treated with bimaxillary surgery: two case reports. Turkish J Orthod. 2013;26;51–57. (DOI: http://dx. doi.org/10.13076/j.tjo2013.26.01_51) Date Submitted: September 2012. Date Accepted: November 2012. Copyright 2013 by Turkish Orthodontic Society 51