Nelson describes 4 cases of alternative approaches to conventional orthognathic surgery processes.
- Facial asymmetry due to condylar hypoplasia:
- Genioplasty Propella
- 2 cuts, 1 horizontal, 1 angular and rotate the middle component
- Genioplasty Propella
- Class 2 due to retrognathic mandible
- Corrected by 4 stages
- Genioplasty
- Start anterior subapical osteotomy
- Corrected by 4 stages
- BSSO advancement
- Complete subapical and inferior repositioning = prevent lateral openbites
- Class 3 due to maxillary hypoplasia AP and vertical.
- 3 Stage process with segmental maxillary osteotomy
- Maxillary advancement
- Extraction of U4s, anterior subapical osteotomy, retracting and rotation to surgically decompensate
- 3 Stage process with segmental maxillary osteotomy
- Mandibular set back
- Class 2 due to maxilla hyperplasia
- Maxillary osteotomy 2 part: horse shoe shaped osteotomy
- Separating dental and skeletal components
- Allow set back of dentoalveolar component and upward positioning of the maxilla
- Maxillary osteotomy 2 part: horse shoe shaped osteotomy
