This paper describes a modification of the combined bilateral sagittal split osteotomy and total subapical osteotomy procedure; a representative case treated with this approach is presented. In addition, diagnostic and treatment planning considerations for the comprehensive surgical-orthodontic therapy of individuals presenting with differential sagittal discrepancy between the mandibular corpus and symphysis are discussed, along with limitations of diagnostic criteria commonly used in cephalometric appraisal of the facial soft tissue outline.
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