Maxillary posterior-superior repositioning and mandibular autorotation with and without genioplasty in skeletal class II malocclusion: Long-term skeletal and condylar stability

To evaluate long-term skeletal and condylar stability following maxillary posterior-superior repositioning with mandibular autorotation in patients with skeletal Class II malocclusion and assess the impact of adjunctive genioplasty on the postoperative outcomes. Sixteen patients underwent Le Fort I osteotomy with posterior-superior repositioning of the maxilla, inducing counterclockwise mandibular autorotation. Genioplasty was performed in 12 patients. Standardized lateral cephalometric radiographs were obtained at four time points: before surgery (T0), 1 month postoperatively (T1), 1 year postoperatively (T2), and > 2 years after surgery (T3). The mandibular condylar volume was measured using computed tomography at T0 and T2. Significant surgical changes in the skeletal landmarks were observed from T0 to T1, with stable skeletal positions maintained until T3. No significant differences in the long-term B-point relapse were found between patients who underwent genioplasty and those who did not. The mean condylar volume decreased by 3.93 ± 4.87%, with no significant difference between the groups. No correlation was found between the B-point relapse and condylar volume changes or genioplasty. Maxillary posterior-superior repositioning with mandibular autorotation provides favorable long-term skeletal and condylar stability in patients with skeletal Class II. Genioplasty did not exhibit significant effects on the postoperative skeletal stability or mandibular condylar remodeling.