Several surgical procedures have been proposed for the treatment of hyperdivergent dentoskeletal deformities. We propose a new osteotomy technique allowing for lengthening and advancement of the mandibular ramus by intra-oral approach.

This technique differs from the conventional sagittal split osteotomyin that which the anterior osteotomy line is not continued until the basilar edge but stopped 5–6mm above it. Cutting of the pterygomasseteric sling is systematically done allowing for the lowering of the mandibular angle. Osteosynthesis is performed by transjugal and intra-oral approaches, using two adjustable miniplates. Our supra-angular technique allows for both elongation of the ramus and advancement of the mandible. Unlike the vertical ramus osteotomy proposed by Caldwell-Letterman, external incision and intraoperative cervical hyperextension are not required.