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Surgery first in orthognathic surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases
Federico Hernández-Alfaro1, Raquel Guijarro-Martínez2, María A Peiró-Guijarro3
1Director, Institute of Maxillofacial Surgery, Teknon Medical Center Barcelona, Barcelona, Spain; Chair, Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Barcelona, Spain.
Summary
The "surgery first" (SF) approach offers expedited correction of maxillofacial deformities, significantly reducing treatment time. This method is highly rated by patients and orthodontists for improving facial aesthetics.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- Skeletal Malocclusion Correction
- Surgical Orthodontics
Background:
- The
- surgery first
- (SF) approach is an alternative for expedited correction of maxillofacial deformities.
- Patient selection and treatment planning are crucial for successful outcomes.
Purpose of the Study:
- To present a specific orthodontic and surgical protocol for the SF approach.
- To evaluate the benefits and limitations of SF in a large patient sample.
- To update the indications for SF in treating maxillofacial deformities.
Main Methods:
- Prospective evaluation of 45 patients undergoing SF.
- Virtual treatment planning with 3D orthodontic setup.
- Orthognathic osteotomies with buccal interdental corticotomies and miniscrew stabilization.
- Orthodontic treatment initiated 2 weeks post-surgery.
Main Results:
- Mean orthodontic treatment duration was 37.8 weeks.
- High patient (9.4/10) and orthodontist (9.7/10) satisfaction scores.
- Bimaxillary surgery was the most common procedure, with esthetics as the primary motivation.
Conclusions:
- The SF approach significantly shortens overall treatment duration.
- SF is highly valued by both patients and orthodontists.
- Careful patient selection, precise planning, and surgeon-orthodontist communication are essential for SF success.
