There have been various studies related to maxillofacial deformities. Since Dr. Obwegesser introduced the sagittal split osteotomy of mandible in 1950s, the development of orthognathic surgery has accelerated. The conventional orthognathic surgery needs both preoperative and postoperative orthodontic treatments.
However, there could be several disadvantages of having orthodontic interventions both before and after orthognathic surgery including a long treatment time, dental caries, gingival recession and root resorption. Other complications associated with preoperative orthodontic treatment are temporary worsening of facial appearance and masticatory discomfort.
Nowadays orthognathic surgery without preoperative orthodontic treatment is on the rise. Since the first orthognathic surgery procedure was performed by Hullihen, many new techniques and methods have been introduced. Afterwards, the concept of surgery first and orthodontics second with the goal of reducing the disadvantages and inconveniences of presurgical orthodontics was proposed.
The normalized postoperative surrounding soft tissues (lips, cheeks and tongue) settle the teeth into better positions after surgery, facilitating remaining orthodontic tooth movement and reducing the total orthodontic treatment period.
Nowadays, the surgeons and the orthodontists as well as the patients begin to pay attention to the first surgery approach. Even if surgery-first approach for correcting skeletal malocclusions has the advantages of shortened total treatment time and early response to a patient’s need, the surgeons and orthodontists should be careful in selecting the cases with the adequate diagnosis. prediction and simulation.
The experience of the surgeons and the orthodontists is one of the most important factors in determining the appropriate treatment method.
