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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?

AP-LC VIEW

AP-OM VIEW

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

 

PROGNATHISM_LAT-v1

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

DISCUSSION:
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)

 

REFERENCES:

1.Plastic Surgery Key.com/mandibular -setback/

2. Treatment of mandibular prognathism PMID 17000450

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