Conventional orthognathic surgery can become challenging when multiple goals such as correction of transverse and anteroposterior discrepancies of the dental arches are aimed. Thus, additional procedures such as midline mandible osteotomy for mandibular constriction and tongue reduction due to true macroglossia may be alternatives to a more functional and aesthetical outcome.

Case Report:

A treatment of a 35-year-old female patient with Class III sagittal skeletal pattern marked by an increased angle facial profile, maxillary retrusion, vertical maxillary deficiency, and mandibular protrusion, a Class III malocclusion associated to an edentulous maxilla, partially dentate mandible, transverse mandibular excess and true macroglossia. With an Index of Orthognathic Functional Treatment Need (IOFTN) grade 5, the patient underwent bimaxillary orthognathic surgery, mandible constriction and partial glossectomy. After about a year of follow-up, the patient demonstrated skeletal stability for the orthognathic procedures as well preservation of tongue function.


The combination of the techniques performed was effective in the treatment of the multifaceted deformities, providing satisfactory function, harmonious facial aspect and enabling effective prosthetic rehabilitation to the patient.

Keywords: Orthognathic surgery, Mandibular constriction, Macroglossia, Partial glossectomy, Mandible osteotomy, Class III malocclusion.
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