Combined surgical and orthodontic treatment of bimaxillary protrusion

Bimaxillary protrusion can be treated effectively in growing patients and in adults with conventional orthodontic therapy. In the adult patient, however, combined surgical and orthodontic treatment modalities may offer distinct advantages over such conventional therapy. Treatment time and possible adverse effects of lengthy and extensive orthodontic therapy may be reduced and optimum esthetic improvement may be facilitated. Those cases that exhibit severe skeletal discrepancies in the vertical, transverse, or sagittal dimensions in addition to dentoalveolar protrusion may be best treated in this manner to simultaneously correct all existing problems and obtain optimal esthetic and functional results. This article delineates the rationale for such therapy and tridimensional diagnostic and treatment-planning considerations from both the orthodontic and surgical standpoints. Case reports illustrate clinically the results obtainable with such treatment.