Advances in the surgery-first orthognathic approach for the treatment of patients with malocclusion

Abstract

Combined orthognathic and maxillofacial treatment is the main approach to correct severe dentofacial deformities, which includes conventional orthognathic surgery (COS) and surgery first approach (SFA).The COS model consists of 3 different treatment phases: preoperative orthodontic debridement, orthopaedic surgery and postoperative orthodontic occlusal adjustment. In order to prevent the deterioration of transient facial deformities caused by preoperative orthodontics and to shorten the overall treatment time as well as to improve patient satisfaction, the surgical first approach (SFA) has been proposed, in which the patient undergoes orthognathic surgery without preoperative orthodontics, or with as little preoperative orthodontics as possible, and then undergoes postoperative orthognathic occlusal refinement. SFA has obvious advantages over traditional combined orthodontic and orthognathic treatment, but at the same time, the selection of indications and contraindications is more stringent. SFA, as an alternative to traditional orthodontic orthognathic treatment, has been one of the hottest research topics in recent years, with increased surgical design and complexity for the operator. This article reviews the advantages, disadvantages, indications, and contraindications of surgical priority orthognathic modalities and orthognathic treatment in traditional modalities, in the hope of providing clinicians with some reference value when choosing treatment modalities.