:Removal of Mandibular Ramus Exostoses by Sagittal Splitting of Exterior Cortical Plate

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For surgical correction of masseteric muscle hypertrophy, Obwegeser-Beckers method, removal of the exostoses at the mandibular angle, is usually performed. However, it is difficult to obtain satisfactory esthetic results by this conventional method. In this paper, a new surgical technique to easily obtain good esthetic results is reported. This technique can remove exostosis at the mandibular ramus without damage to the inferior alveolar neurovascular bundle and surrounding tissue.<BR>The method is as follows:<BR>1. A Lindemann bar is used to cut through the exterior cortical plate of the ramus and the area of the antegonial notch. Then, a bone saw is used to cut through the cortical plate on an oblique line.<BR>2. A splitting chisel is directed and driven inward to the osteotomy line. The exterior cortical plate of the mandibular ramus is removed, and so, this portion has thin, facial esthetics which are improvable.
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