[Orthognathic surgery: from the essential to the superfluous]

The majority of adult patients who consult for smile reconstruction or for functional problems can be satisfied by benefitting from orthodontic treatment. This treatment, whatever the orthodontic technique, is carried out following the establishment of a diagnosis and treatment plan taking into account some restrictions of a prosthetic, periodontal or financial nature. There are, however, situations in which the esthetic and functional balance is severely affected or quite simply impossible to correct without modifying the bone structures. Orthognathic surgery is essential in such cases. In this article we will deal in particular with three frequently encountered situations: openbite, Class III and finally Class II skeletal discrepancies. The aim will be to try to define the interest that these so-called ortho-surgical treatments represent and at the same time consider the alternatives.