Authors of section

Authors

Scott Bartlett, Michael Ehrenfeld, Gerson Mast, Adrian Sugar

Executive Editor

Edward Ellis III

General Editor

Daniel Buchbinder

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Transoral approach to the lateral mandibular body

1. Principles

Vestibular incisions
A transoral approach is used for the majority of mandible body osteotomies.
Mandibular body osteotomies are usually performed in the areas of the premolars and first molars. Sulcular incisions from the canine to the posterior molars with anterior and posterior extensions into the vestibule (marginal incisions, A) or paramarginal incisions may be used (B).

Lacerations

2. Vestibular incision

Unless contraindicated, infiltrate the area with a local anesthetic containing a vasoconstrictor.
Make an incision along the gingival margin down to the alveolar crest.

transoral approach to the lateral mandibular body

3. Exposure

For adequate exposure a broad based mucoperiosteal flap is dissected starting at the gingival margin. Dissecting downward, the mental foramen with the mental nerve needs to be identified and freed. The dissection is continued in the subperiosteal plane down to the lower border of the mandible.

transoral approach to the lateral mandibular body

4. Wound closure

After checking for hemostasis the wound is carefully sutured. Interdental sutures are used to reposition the papillae.

transoral approach to the lateral mandibular body