Comparison of the aesthetic impact on the mandibular angle of two types of osteotomy.

The growing aesthetic demand for projection and definition of the mandibular angle has challenged oral and maxillofacial surgeons, requiring new approaches to osteotomies during orthognathic surgery. This study was undertaken to compare the conventional sagittal split osteotomy (SSO) with anterior oblique osteotomy (AOO) regarding their effects on the mandibular angle in both bone and soft tissue outcomes. A longitudinal observational cohort study was conducted with patients who underwent orthognathic surgery, including pre- and postoperative computed tomography and photographic examinations with a minimum follow-up interval of 6 months. Measurements were performed using Dolphin Imaging software. No significant differences were observed in the angle and vertical height of the mandible between the techniques. However, AOO was more effective in enhancing the lateral projection of the mandibular angle, with a significant increase in gonial distance (P = 0.004). In the soft tissues, AOO also demonstrated a significant effect on horizontal projection in coronal slices (P < 0.001), whereas three-dimensional reconstructions revealed no significant changes. These findings highlight that anterior oblique osteotomy improves mandibular angle projection when compared to conventional sagittal split osteotomy.