Surgery-first segmental orthognathic surgery for treatment of hemimandibular elongation: a novel modified modality.

Jiawen Si, Yilang Du, Jingyang Huang, Hongbo Yu, Guofang Shen

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Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Jiawen SiDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

Yilang DuDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

Jingyang HuangDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

Hongbo YuDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

Guofang ShenDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

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6 · The paper itself

Abstract

Background: The application of a surgery-first approach in patients with hemimandibular elongation (HE) remains poorly defined. In this pilot study, we introduce a modified surgery-first segmental orthognathic surgery (OGS) technique that integrates novel osteotomy design and structural precision to address HE. Methods: Nine patients with HE underwent segmental Le Fort I osteotomy, bilateral sagittal split ramus osteotomy (BSSRO), and unilateral mandibular body osteotomy, using both virtual surgical planning (VSP) and individualized cutting guides. Surgical accuracy was evaluated by comparing three-dimensional (3D) models obtained at 1 week postoperatively (T1) with VSP. Mid-term skeletal stability was assessed by comparing 3D models at T1 with those at 6-12 months postoperatively (T2). Symmetry-related parameters (chin deviation, chin rotation, bilateral mandibular body length discrepancy, and asymmetry index) were measured and compared. Results: All patients healed uneventfully without major complications. Surgical accuracy analysis showed a mean 3D deviation of 1.58 ± 0.39 mm between VSP and T1. Significant improvements were observed in all symmetry parameters at T1 ( Conclusions: This pilot study demonstrates that the modified surgery-first segmental OGS technique achieves good surgical accuracy, immediate improvement in facial symmetry, and acceptable mid-term skeletal stability. This approach, integrating a unique osteotomy design, VSP, and 3D-printed cutting guides, offers a promising preliminary solution for complex facial asymmetry.

Indexed as

hemimandibular elongationmandibular asymmetrymandibular body osteotomysurgery-firstvirtual surgical plan

Identifiers

PMID42465870

DOI10.3389/fsurg.2026.1838908

PMCPMC13372763

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