Oral surgeons' considerations in surgical orthodontic treatment

The orthognathic surgeon seldom has to consider further growth and development of the adult jaws. There are, however, limitations in the adult of certain orthodontic procedures that are effective in the young; rapid palatal expansion, for example. The surgeon and the orthodontist must be aware of other procedures that may be substituted. The adult patient has social, economic, and psychological demands that differ from the young. These may mandate a reversal of the traditional staging of orthodontics first, surgery to follow. Instead, consideration can be given to doing only that orthodontics needed to permit surgery, then surgery to correct the skeletal problems, followed by whatever orthodontics are necessary or desired. Various symptoms of MPD are present in most patients with jaw abnormalities and malrelationships. There must be an awareness that trying to provide relief without correcting the structural problem is treating only symptoms. There also must be realization, especially on the part of the patient, that correcting the jaw deformity does not necessarily mean that symptoms will be gone or, if gone, will not recur. Above all, the orthodontic and surgical team should strive to provide the patient with the maximum function compatible with the appearance the patient desires and do it with the least required amount of surgery and orthodontics.