A Novel Osteotomy Technique for Treatment of Mandibular Deficiency: A Brief Clinical Study Using the Barakat Modification

Mandibular deficiency correction demands precise control of both advancement and rotation to achieve optimal function and facial harmony. The Barakat modification introduces an intraoral adaptation of the inverted L osteotomy, which enables simultaneous mandibular advancement and controlled counterclockwise rotation, eliminating the need for grafting and reducing morbidity. Cephalometric evaluation demonstrated consistent forward mandibular repositioning (mean SNB increase ≈ +1 degree) accompanied by reductions in FMA (≈ -3 to -5 degrees) and gonial angle (≈ -2 to -4 degrees), confirming effective rotational control with vertical shortening. Postoperative assessments revealed a stable occlusion, accurate bony alignment, and enhanced lower facial proportions, with no complications. The Barakat modification offers a predictable, minimally invasive solution for managing mandibular deficiency, combining advancement precision with rotational control to deliver superior aesthetic and functional outcomes.