Current concept of the surgery-first orthognathic approach

Area of Science:

• Dentistry
• Orthodontics
• Oral and Maxillofacial Surgery

Background:

• Traditional orthognathic surgery typically follows extensive presurgical orthodontic treatment.
• The surgery-first orthognathic approach (SFOA), also known as the surgery-first approach (SFA), is increasingly adopted without presurgical orthodontics.
• Despite growing interest and publications, the SFA lacks standardization, with varied protocols among practitioners.

Purpose of the Study:

• To review the historical development and evolution of the SFA.
• To discuss current concepts and clinical applications of the SFA based on extensive experience.
• To address ongoing debates, advantages, disadvantages, indications, and contraindications of the SFOA.

Main Methods:

• Literature review of articles on the SFA.
• Synthesis of clinical experiences from the authors over 15 years.
• Analysis of the SFA's application in different malocclusion types and facial asymmetry.

Main Results:

• The SFA has demonstrated effectiveness in treating Class III malocclusion, Class II malocclusion, and facial asymmetry.
• Significant debate persists regarding the SFA, with several unresolved issues.
• The SFA is not yet a standardized procedure, with variations in surgical protocols.

Conclusions:

• The SFA is a viable alternative in specific orthodontic and surgical cases.
• Further research and standardization are needed to optimize SFA protocols.
• This review aims to enhance understanding of the SFA for surgeons and orthodontists.