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Current Concepts in Orthognathic Surgery.

Sanjay Naran1,2, Derek M Steinbacher1,2, Jesse A Taylor1,2

  • 1Park Ridge, Ill.; New Haven, Conn.; and Philadelphia, Pa.

Plastic and Reconstructive Surgery
|May 26, 2018
PubMed
Summary

Orthognathic surgery corrects skeletal discrepancies, utilizing virtual planning and advanced techniques like fat grafting. It also offers treatment for obstructive sleep apnea, with careful consideration of outcomes and complications.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Plastic Surgery

Background:

  • Orthognathic surgery addresses complex skeletal discrepancies of the face.
  • Advances in surgical planning and techniques are continually evolving.
  • Controversies exist regarding surgical sequencing and patient selection.

Purpose of the Study:

  • To outline the goals and advances in orthognathic surgery.
  • To discuss surgical principles, including sequencing and virtual planning.
  • To review adjunct procedures, outcomes, and complications.

Main Methods:

  • Literature review on surgical sequencing (maxilla-first vs. mandible-first).
  • Discussion of "surgery first" protocols and patient candidacy.
  • Description of virtual surgical planning and its application.
  • Exploration of soft-tissue augmentation and obstructive sleep apnea treatment.

Main Results:

  • Virtual surgical planning is an emerging standard for precise orthognathic movement.
  • Sequencing of osteotomies and the "surgery first" approach offer alternative treatment pathways.
  • Adjunct procedures like osseous genioplasty and fat grafting enhance outcomes.
  • Orthognathic surgery demonstrates utility in treating obstructive sleep apnea.

Conclusions:

  • Orthognathic surgery is a multifaceted treatment for skeletal deformities with evolving techniques.
  • Virtual planning and tailored sequencing optimize surgical outcomes.
  • Patient-reported satisfaction and psychological impact are crucial for assessing success.