Orthognathic Surgery for Aesthetic and Functional Outcomes: A Multidisciplinary Perspective
Main Article Content
Abstract
Orthognathic surgery is a cornerstone in the correction of dentofacial discrepancies, offering both functional and aesthetic improvements for patients with skeletal malocclusions and facial asymmetries. This surgical approach requires a multidisciplinary collaboration among orthodontists, maxillofacial surgeons, and rehabilitation specialists to ensure optimal outcomes.
This review delves into the comprehensive treatment pathway, beginning with preoperative orthodontic preparation, where dental decompensation and arch coordination play crucial roles. The integration of digital planning tools and virtual surgical simulations has significantly enhanced precision in treatment planning, allowing for customized osteotomies that cater to individual anatomical needs.
Beyond skeletal realignment, orthognathic surgery has profound implications for occlusal stability, temporomandibular joint function, airway dynamics, and overall facial aesthetics. The impact of different surgical techniques on obstructive sleep apnea, speech function, and soft tissue response will be explored.
Additionally, the review will address postoperative rehabilitation, emphasizing strategies to enhance recovery, minimize complications, and ensure long-term stability. Patient satisfaction remains a critical measure of success, influenced by both objective surgical outcomes and subjective perceptions of facial balance and symmetry.
Finally, emerging trends in technology-driven orthognathic surgery, such as artificial intelligence-assisted planning, 3D-printed patient-specific implants, and robotic-assisted osteotomies, will be discussed, providing insight into the future of maxillofacial surgery.
By integrating innovative techniques with a patient-centered approach, orthognathic surgery continues to evolve, offering transformative results that extend beyond aesthetics to significantly improve functionality and quality of life.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Birbe J, Serra Serrat M. Orthodontics in orthognathic surgery. RCOE. 2006;11(5-6):547-557.
3. Posnick JC. Orthognathic Surgery: Principles and Practice. St. Louis, MO: Elsevier; 2014.
4. Wang Y, Lee Y, Baek SH. Surgery-first approach in Class III treatment: Systematic review of outcomes. Am J Orthod Dentofac Orthop. 2015;148(3):401-415.
5. Miloro M, Han MD, Kwon TG, Xi T, Borba AM, Reyneke JP, Caminiti M. Predicting the future focus of orthognathic surgery: Outcome-driven planning and treatment with function, aesthetics, and occlusion as key indicators. J Oral Maxillofac Surg. 2024;82(6):1329-1335.
6. Raffaini M, Cocconi R, Spinelli G. Simultaneous rhinoseptoplasty and orthognathic surgery: outcome analysis of 250 consecutive patients using a modified Le Fort I osteotomy. Aesthetic Plast Surg. 2018;42(5):1090-1100.
7. Villegas, C. U. F. S., Uribe, F., Sugawara, J., & Nanda, R. (2010). Expedited correction of significant dentofacial asymmetry using a “surgery first” approach. J Clin Orthod, 44(2), 97-103.
8. Nordblom NF, Büttner M, Schwendicke F. Artificial intelligence in orthodontics: critical review. J Dent Res. 2024;103(6):577-584.
9. Nadershah M, Mehra P. Orthognathic surgery in the presence of temporomandibular dysfunction: what happens next? Oral Maxillofac Surg Clin North Am. 2015 Feb;27(1):11-26.
10. Birbe J, Costa de la Higuera C. Orthognathic surgery and its influence in the temporomandibular joint. Rev Esp Ortod. 2011;41:133-142
11. Goodday R. Diagnosis, treatment planning, and surgical correction of obstructive sleep apnea. J Oral Maxillofac Surg. 2009;67:2183-2196.
12. Posnick JC, Adachie A, Singh N, Choi E. Silent sleep apnea in dentofacial deformities and prevalence of daytime sleepiness after orthognathic and intranasal surgery. J Oral Maxillofac Surg. 2018;76:833-843.
13. O’Ryan F, Lassetter J. Optimizing Facial Esthetics in Orthognathic Surgery Patients. J Oral Maxillofac Surg. 2011;69:702-715.
14. Ruggiero F, Borghi A, Bevini M. Soft tissue prediction in orthognathic surgery: improving accuracy by means of anatomical details. PLoS ONE. 2023;18(11):e0294640.
15. DeSesa CR, Metzler P, Sawh-Martinez R, Steinbacher DM. Three-dimensional nasolabial morphologic alterations following Le Fort I. Plast Reconstr Surg Glob Open. 2016;4(8):e848.
16. Sun AH, Steinbacher DM. Orthognathic surgery and rhinoplasty: simultaneous or staged? Plast Reconstr Surg. 2018;141(2):322-329.
17. Posnick JC. Sequencing of Orthognathic Procedures: Step-by-Step Approach. In: Orthognathic Surgery: Principles and Practice. Elsevier; 2014:441-448.
18. Joan Birbe Foraster, Barbara Anento Moreno, Enric Bardalet Casals, Teresa Flores Fraile, Emilio Macias Escalada. Dysplasies faciales verticales : diagnostic, plan de traitement et thérapeutique∗. L'Orthodontie Française. 2010;81(4):301-314. doi:10.1051/orthodfr/2010027
19. Fisher EL, Morrison S, Susarla SM, Ettinger R. Planning the Cut: Gender-Affirming Considerations in Orthognathic Surgery. J Oral Maxillofac Surg. 2024 Nov;82(11):1343-1346.
doi: 10.1016/j.joms.2024.07.017
20. Farkas LG, Munro IR (eds): Anthropometric facial proportions in medicine. Charles C Thomas, 1987, p 344
21. Raffaini M, Perello R, Tremolada C, Agostini T. Evolution of Full Facial Feminization Surgery: Creating the Gendered Face With an All-in-one Procedure. J Craniofac Surg. 2019 Jul;30(5):1419-1424
22. Liebregts J, Xi T, Schreurs R. Three-dimensional virtual simulation of alar width changes. Int J Oral Maxillofac Surg. 2016;45(10):1315-21.
23. Posnick JC, Kinard BE. Orthognathic surgery has a significant positive effect on perceived personality traits and perceived emotional expressions in long face patients. J Oral Maxillofac Surg. 2019;77(3):408.e1-408.e10.
24. Posnick JC, Kinard BE. Orthognathic surgery and perceived personality changes. J Oral Maxillofac Surg. 2019;77(3):408.e1-408.e10.
25. Brandtner C, Hachleitner J, Rippel C, Krenkel C, Gaggl A. Long-term skeletal and dental stability after orthognathic surgery of the maxillo-mandibular complex in Class II patients with transverse discrepancies. J Craniomaxillofac Surg. 2015 Oct;43(8):1516-21.
doi: 10.1016/j.jcms.2015.07.007. Epub 2015 Jul 26. PMID: 26293193.