SURGERY FIRST ORTHOGNATHIC APPROACH

Surgery first is an alternative methodology to conventional orthognathic surgery, which performs directly an orthognathic surgery, without the previous orthodontic preparation, followed by a post-surgical orthodontic treatment to achieve the desired final dental alignment. The concept of this technique is for no prior tooth movement or minimal tooth decompensation for a shorter period in cases of occlusal interference, to use surgery to rapidly achieve facial esthetic improvement that is usually the patient¿s chief complaint at the beginning of the treatment. This approach was made possible by replacing pre-surgical orthodontic treatment with surgical modifications of multiple osteotomies good laboratory work and successful utilization of regional acceleratory phenomenon.