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Surgical correction of severe mandibular protrusion had been frequently performed by the Obwegeser II surgical procedure or combined mandibular osteotomy. Although clinically acceptable results had been achieved by applying the former method, certain problems such as intraoperative complication and postoperative stability had not been completely solved. The latter method had been considered to solve the problems. There were few articles discussing it, despite combined mandibular osteotomy used for the treatment of mandibular deformity in Japan.The purpose of this paper was to discuss the clinical problems of the Obwegeser II method and to elucidate the surgical criteria for producing better results.Case 1 was a 22-year-old man, who had protrusion of the upper lip and mandible. W e treated him with maxillary anterior segmental osteotomy and sagittal splitting ramus osteotomy combined with mandibular anterior segmental osteotomy.Case 2 was a 20-year-old woman, who had severe mandibular protrusion. We treated her with intraoral vertical ramus osteotomy combined with mandibular anterior segmental osteotomy.Results of both cases were excellent, and literature was cited in our report.

Surgical Correction of Severe Mandibular Protrusion by Ramus Osteotomy Combined with Mandibular Anterior Segmental Osteotomy