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52 yo/F patient presents with neck discomfort.

No prior trauma, corticosteroid/opioId regimen or carcinoma is reported. Dental surgery is reported.

What do you see?



Multiple intramedullary screws are seen at the mandibular angles – best seen on the AP-OM view.



The lateral view shows the intra-medullary screws again. This is the radiographic presentation of treatment for prognathism.

In this condition, the mandible is positioned severely anterior to the maxilla. (class III malocclusion) 1)
Less than 0.3 % of patients present¬† with this, but severe cases may lead to sleep apnea. Sagittal split ramus osteotomy is a common orthodontic corrective procedure. (2) Why don’t more patients present with this osseous malformation? 53 genes are linked with this malocclusion. Therefore further collaborative efforts are required. (3)



1.Plastic Surgery -setback/

2. Treatment of mandibular prognathism PMID 17000450

3. J ClinMed 2023 Apr. 19:12(9):3212 doi: 10.3390.jcm12093212