Extraoral vertical ramus osteotomy (EVRO) is used in orthognathic surgery for the treatment of mandibular deformities. Originally, EVRO required postoperative intermaxillary fixation (IMF). EVRO has been developed using rigid fixation, omitting postoperative IMF. We examined retrospectively the long-term stability and postoperative complications for patients with mandibular prognathism who underwent EVRO with internal rigid fixation. Patients who were treated with EVRO for a mandibular prognathism in the period 2022–2023 at the Department of Plastic Surgery of the multidisciplinary clinic of the Tashkent Medical Academy (N = 12). Overjet and overbite were calculated digitally and cephalometric analyses were performed preoperatively, and at six months, and 18 months postoperatively. There was a general setback of the mandible, decreased gonial angle and reduced degree of skeletal opening. Excellent dental and vertical skeletal stabilities were seen up to 18 months postoperatively, although relapse was seen sagitally up to six months postoperatively. Since the overjet did not show any significant change over time, the sagittal skeletal changes have been attributed to dental compensation. There was no permanent damage to the facial nerve and 8.3% neurosensory damage to the inferior alveolar nerve was observed.

Performed preoperatively, and at six months, and 18 months postoperatively

Akin RK, Walters PJ: Experience with intraoral vertical subcondylar osteotomy. Journal of Oral Surgery. 1975, 33:342-5.

Al-Bishri A, Barghash Z, Rosenquist J, Sunzel B. Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patients' records. International Journal of Oral and Maxillofacial Surgery. 2005, 34:247-51.

Ayoub AF, Lalani Z, Moos CF, Wood GA: Complications following orthognathic surgery that required early surgical intervention: fifteen years' experience. International Journal of Oral and Maxillofacial Surgery. 2001, 16:138 44.

Astrand P, Berglung L, Nord PG: Oblique sliding osteotomy of the mandibular rami in 55 patients with mandibular prognathism. International Journal of Oral Surgery. 1973, 2:89-101.

Blinder D, Peleg O, Joffe T, Teicher S: Intraoral vertical ramus osteotomy: a simple method to prevent medial trapping of the proximal fragment. International Journal of Oral and Maxillofacial Surgery. 2010, 39:289-91.

Hajir MY, Ayoub AF, Millett DT: Three-dimensional assessment of facial soft-tissue asymmetry before and after orthognathic surgery. International Journal of Oral and Maxillofacial Surgery. 2004, 42:396-404.

Calderon S., Gal G., Anavi Y., Gonshorovits M. Techniques for ensuring the lateral position of the proximal segment following intraoral vertical ramus osteotomy. Journal of Oral and Maxillofacial Surgery 1992, 50:1044-7.

Risdon F. Ankylosis of the temporomaxillary joint. Journal of the American Dental Association. 1922, 10:1933-7.

9. Severt TR, Proffitt WR: The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. International Journal of Adult Orthodontics and Orthognathic Surgery, 1997, 12:171-6.

10. Li Q, Zhang F, Li X, Chen F: Genome scan for locus involved in mandibular prognathism in pedigrees from China. PLOS One. 2010, 5:e12678.

Werther Jr, Hall HD: Vertical ramus osteotomy and the inverted-L osteotomy. Maxillofacial surgery. 2000, 313.

Leung Y, Wang R, Wong NS, Lee DT, Au SW, Choi WS, Su YS: Surgical morbidities of sagittal split ramus osteotomy versus intraoral vertical ramus osteotomy for the correction of mandibular prognathism: a randomized clinical trial. International Journal of Oral and Maxillofacial Surgery. 2021, 50:933-9.

Thornes K, Gilhuus-Mo OT: The surgical technique of vertical subcondylar osteotomy for correction of mandibular prognathism. A 10-year survey. Acta Odontologica Scandinavica. 1987, 45:203-11.

Hall HD, McKenna SJ: Further refinement and evaluation of intraoral vertical ramus osteotomy. Journal of Oral and Maxillofacial Surgery. 1987, 45:684-8.

Malekzadeh BO, Ivanoff KJ, Westerlund A, MadBeigi R, Ornell LO, Widmark G. Extraoral vertical ramus osteotomy combined with internal fixation for the treatment of mandibular deformities. British Journal of Oral and Maxillofacial Surgery. 2022, 60:190-5.

Hoogensley N, Stanwick A, Espeland L: Extraoral vertical subcondylar osteotomy with rigid fixation for correction of mandibular prognathism. Comparison with bilateral sagittal split osteotomy and surgical technique. Journal of Craniomaxillofacial Surgery. 2013, 41:212-8. 10.

Peleg O, Mahmud R, Shuster A, Arbel S, Kleinman S, Mijiritsky E, Yankulovichi S: Vertical ramus osteotomy, is it still a valid tool in orthognathic surgery?? International Journal of Environmental Research and Public Health 2022, 19: 10171.

Wang JH, Waite DE: Vertical osteotomy vs sagittal split osteotomy of the mandibular ramus: comparison of operative and postoperative factors. Journal of Oral Surgery. 1975, 33:596-600.

Nordin T, Nyström E, Rosenqvist J, Astrand P: Extraoral or intraoral approach in the oblique sliding osteotomy of the mandibular rami? Clinical experience and results. Journal of Craniomaxillofacial Surgery. 1987, 15:233 7.

Lee D.T., Wang R., Wong N.S., Leung Y.Y. Postoperative stability of two common ramus osteotomy procedures for the correction of mandibular prognathism: a randomized controlled trial. Journal of Craniomaxillofacial Surgery. 2022, 50:32-9.

Nihara J, Takeyama M, Takayama Y, Muto Y, Saito I Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy. International Journal of Oral and Maxillofacial Surgery. 2013, 42:62-70.

Thornes K, Wiest PJ: Stability after vertical subcondylar ramus osteotomy for correction of mandibular prognathism. International Journal of Oral and Maxillofacial Surgery. 1988, 17:242-8.

Mobarak KA, Krogstad O, Espeland L, Lyberg T: Stability of extraoral vertical ramus osteotomy: plate fixation versus maxillomandibular/skeletal suspension wire fixation. International Journal of Adult Orthodontics and Orthognathic Surgery. 2000, 15:97-113.

Kim J, Park JH, Jung HD, Jung YS: Safety and stability of postponed maxillomandibular fixation after intraoral vertical ramus osteotomy. Journal of Craniofacial Surgery. 2018, 29:2226-30.

Hines E, Kent J, Gforgiadf, NGMD: Surgical treatment of developmental jaw deformities. Plastic and reconstructive surgery. 19731, 51:580