Orthognathic surgery involves correcting musculoskeletal, dento-osseous, and soft tissue deformities of the jaws and associated structures through a combination of orthodontics and oral and maxillofacial surgery. It is best performed after growth is complete to avoid potential need for resurgery. There are several classifications of orthognathic surgeries including maxillary, mandibular, and combined surgeries. Maxillary surgeries involve osteotomies of different segments of the maxilla like the anterior segment or total maxilla. Mandibular surgeries involve osteotomies like ramus, body, or genioplasty osteotomies.

1. Orthognathic Surgery
By Kuo Yuet Yuen
DDS/DEG/10-1/0019

2. Definition
• ‘Orthognathic ‘comes from the Greek word
• ‘ortho’ - straighten
• ‘gnathia’ - jaw.

3. Definition
• The art and science of diagnosis, treatment
planning and execution of treatment by
combining orthodontics and oral and
maxillofacial surgery to correct
musculoskeletal, dento-osseous, and soft
tissue deformities of the jaws and associated
structures.

4. Timing for Surgery
• If patient is having severe psychosocial
problems, surgery in actively growing
patient.
• But resurgery may be required later on.
• The best timing for Orthognathic surgery is ---
after the growth potential for the patient is
over.

5. Classification
1. Maxillary Surgeries
2. Mandibular Surgeries
3. Combined Surgeries

6. Maxillary Surgeries
a. Segmental osteotomy of the maxilla
i. Single tooth osteotomy
ii. Corticotomy
iii. Anterior segmental maxillary osteotomy
• Wassmund technique
• Wunderer technique
• Epker’s anterior maxillary osteotomy
• Cupar’s technique
iv. Posterior subapical osteotomy of maxilla
• Kufner
• Schuchardt
b. Total maxillary osteotomy
i. Le fort I osteotomy
ii. Le fort II osteotomy
iii. Le fort III osteotomy

7. Mandibular Surgeries
a. Ramus osteotomy
i. Extraoral vertical ramus osteotomy (EVRO)
ii. Intraoral vertical ramus osteotomy (IVRO)
iii. Bilateral sagittal split osteotomy (BSSO)
b. Body osteotomy of mandible
c. Subapical body osteotomy
i. Anterior subapical osteotomy
ii. Posterior subapical osteotomy
iii. Total subapical osteotomy
d. Genioplasty
i. Horizontal osteotomy with anteroposterior reduction
ii. Double sliding horizontal osteotomy
iii. Vertical reduction genioplasty
iv. Tenon technique
v. Alloplastic augmentation