Basic and Advanced Operative Techniques in Orthognathic Surgery

Orthognathic surgical procedures have been developed to reposition the jaws and have been traditionally used in the dentate patient to correct a skeletal malocclusion; these procedures are usually carried out with orthodontic control of the dentition to produce the best results. The majority of the clinical cases of maxillary deformities can be solved by three basic os‐ teotomies: the LeFort I type maxillary osteotomy (LFI), the bilateral sagittal split osteotomy of the mandible (BSSO) and the horizontal sliding osteotomy of the mandibular symphysis (genioplasty).The LeFort I osteotomy, as described by Obwegeser in 1965, manages the mid‐ face; it can be performed as a single-piece monobloc technique or it can be executed as a multisegment procedure or with a distraction approach such as SARPE (Surgically Assisted Rapid Palatal Expansion). The BSSO and the genioplasty, described by the same author in 1955 and in 1957, respectively, allows the surgeon to modify the mandible.[1-3]