Simultaneous surgical repositioning of the maxilla, mandible, and chin

Abstract

The challenges to achieve three dimensional facial proportionality and occusal stability in many patients with complex dentofacial deformity have been met by the development and use of the maxilla, mandible, and chin surgery techniques in combination with efficient orthodontic treatment. There is a clinical, biological, and biomechanical foundation for simultaneous surgical repositioning of the maxilla, mandible, and chin in a significant proportion of adult and adolescent patients. A combination of the surgical and orthodontic approach may provide increased treatment efficiencies and optimal esthetic results. Art and science to determine the treatment objectives, specifically, the desired soft tissue changes are firstly established by using the clinician's "esthetic sense" of the facial beauty and proportion aided to a few cephalometric guidelines. In this sense, the dependence on the clinician's "esthetic eye" by Dr. Bell is more important in analyzing the facial proportion than the satisfaction of rigid cephalometric norms. The purpose of this article was to elucidate the indication for simultaneous surgical repositioning of the maxilla, mandible, and chin, and to describe the clinical cephalometric analysis for orthognathic surgery. Representative 6 case reports were presented and discussed to illustrate the esthetic, orthodontic, and surgical treatment objectives with long-term follow-up.