Orthodontic considerations to reduce postsurgical relapse

Despite the advances in diagnostic and orthognathic surgical techniques, a certain amount of dental or skeletal relapse occurs in orthodontically and surgically treated cases. The interaction of orthodontic therapy with the anticipated surgical procedure must be carefully analyzed and all aspects of the dento-skeletal malocclusion considered if facial balance, good perioral function, and stability are to be achieved. The role of different elements as they relate to the orthodontic stability, such as dental (eg, leveling and extraction patterns), periodontal (eg, gingival graft), skeletal (eg, maxillary expansion and alveolar distortion), and muscular (eg, tongue size and posture) factors, as well as the roles of growth and the airway are discussed and illustrated.