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Orthognatic Surgery

Orthognathic surgery is surgical procedure used to correct anomalies of the facial bones, and specifically of the maxillar and mandible. Those facial conditions can be related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that cannot be easily treated with braces.

These procedures are performed in collaboration with an orthodontist in order to achieve a centric relation and occlusion post-operatively as well as obtain well-balanced facial features.

Orthognathic surgical planning should derive primarily from aesthetic considerations, and these should be based not on rigid cephalometric and anthropometric norms but on the aesthetic sense of the surgeon. The principles underlying aesthetic surgical treatment planning for orthognathic surgery can be summarized as follows.

First, the support of the facial soft tissues is a critical factor in deter- mining the aesthetic success of orthognathic surgery. Soft tissue goals must, to a large extent, influence the direction and extent of skeletal displacements. Second, appropriate soft tissue support can be achieved more predictably by expanding skeletal volume than by reducing it. Third, efforts to expand the facial skeleton frequently result in skeletal disproportion, which under the appropriate conditions can be extremely attractive. If these principles are applied in the context of achieving a stable, class I occlusal result, optimal aesthetics results can be achieved in facial skeletal surgery.

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