Patient Satisfaction Vertical Ramus Osteotomy Patient Specificosteosynthesis Fixation Versus MMFmandibular Prognanthism

Inclusion Criteria: All subjects were required: * Patients with mandibular prognanthism indicated for mandibular setback. * All ages \>18 years * Patients should be free from any systemic disease that may affect normal healing of bone, and predictable outcome. * Patients with good general condition allowing surgical procedure under general anesthesia. * Patients with physical and psychological tolerance Exclusion Criteria: * History of mandibular trauma * Previous orthognathic surgery * Degenerative disease of temporomandibular joint * Craniofacial syndrome such as cleft lip or palate * Follow up period will be less than 6 months