Evaluating the Efficacy of Vertical Ramus Osteotomy With Iliac Graft Versus Bilateral Sagittal Split Osteotomy for the Correction of Mandibular Deficiency in Skeletal Class II Cases Management. A Randomized Controlled Trial
* Patients will be collected from faculty of dentistry * bilateral vertical ramus osteotomy (VRO )with iliac graft group (group I):- 10 patients will be treated via VRO and iliac crest or * bilateral sagital spilt osteotomy (BSSO) group (group II):- 10 patients will be treated via BSSO * All patients will be studied by comprehensive clinical oral and maxillofacial examination and lateral cephalometric radiographic analyses, within 1 week before the surgery (T0), immediately after the surgery (T1), and 6 months after surgery (T2). * All lateral cephalometric radiographs and clinical photographs must be standardized for all cases. * After pre-surgical orthodontic treatment , a lateral cephalograph Will be obtained for planning the surgical movement of both jaws * Surgical models and surgical stent will be fabricated. * All surgical procedures will be performed under nasal intubation and general anesthesia to surgically reposition the maxilla in standard LeFort I setback fosteotomy; the BSSO group will be underwent BSSO, and VRO group will be underwent VRO * The bony segments will be fixed in the new position with the use of custom made plates (specific for each patient )
• patients with age above 18 years old suffered from skeletal class II with severe mandibular deficiency