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MI lingual corticotomy of the vertical mandibular ramus (Step 6) and positioning of the MI orthognathic instruments (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) are shown on graphic illustrations (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) (a, b) and on a human cadaver (Department of Anatomy and Embryology, University of Maastricht, the Netherlands) (c, d). Note the 45-degree inclination of the small Md1 channel retractor toward the mandibular vertical ramus just above the lingula. Clinical pictures made by ©Valérie Swennen-Boehlen. All rights reserved

MI access toward the buccal corticotomy of the right horizontal mandibular ramus (Step 2) and positioning of the MI orthognathic instruments (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) are shown on graphic illustrations (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) (a–c). Note how the “Operating Surgeon” performs a 45-degree turn to the left with the small Md1 channel retractor to identify the right antegonial notch

MI lingual corticotomy of the vertical mandibular ramus (Step 6) and positioning of the MI orthognathic instruments (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) are shown on a graphic illustration (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) (a) and a synthetic skull (b). Note that the lingual corticotomy is initiated by the use of a “pine-tree burr” parallel to the lower occlusal plane. Clinical picture made by ©Valérie Swennen-Boehlen. All rights reserved

MI lingual corticotomy of the vertical mandibular ramus (Step 6) and positioning of the MI orthognathic instruments (L1® MI Orthognathics, KLS Martin, Tuttlingen, Germany) are shown on a synthetic skull (a, b). Note the particular inclinations of both small Md1 channel retractors positioned in the buccal and lingual subperiosteal tunnels. Note that according to surgeon’s preferences, a reciprocating saw can also be used (b). Clinical pictures made by ©Valérie Swennen-Boehlen. All rights reserved