Surgical orthodontics: maxillary procedures

The greatly increased use of maxillary surgery in the last five years has widened the possibilities for correction of dentofacial deformities. The best result in occlusion and esthetics in each situation is the goal that the orthodontist and oral surgeon must keep in mind: working together. While unfortunate side effects can occur, the experience of teams using well-managed orthognathic surgical methods shows a very good success record. The indications and treatment procedures for anterior, posterior and total maxillary osteotomies were discussed. Some of the conditions which can be well-treated are maxillary protrusion and retrusion, anterior deep and open bites, lip imbalance due to dental protrusion or excess vertical dimension, and maxillary asymmetries. The limitations of orthodontic practice without the inclusion of appropriate surgical procedures exclude real help for many of the people who need it most. We must be realistic in evaluating our achievements so that constant improvement is possible.