IVRO and Inverted-L-Osteotomy in the Mandible

IVRO: Vertical osteotomies in the ascending ramus of the mandible are accessed via transoral approach. The osteotomy is performed from the lateral mandibular side and should be located dorsal to the lingula on the lingual side in order not to injure the neurovascular bundle of the mandibular canal. If angulated saws, burrs or Piezo surgery are not available an extraoral approach must be considered. The inverted L-osteotomy represents a variant of vertical osteotomies in the ascending mandibular ramus. It can be used when vertical displacements in particular do not play a role. Attention must be paid to the function of the temporal muscle. Inverted L and vertical ramus osteotomy can also be used when anatomic reasons prohibit BSSO. A longer period of intermaxillary fixation must be accepted.