Johan P. Reyneke - Essentials of Orthognathic Surgery

Fig 2-85Patients with high mandibular plane angle Class III occlusion treated with counterclockwise rotation of the maxillomandibular and advancements benefit because the D-point moves upward and forward, the incisors move backward, and the airway is enhanced. Presurgical (a) and postsurgical (b) CBCT scans demonstrate the advantage of this approach (red rectangles) .

Orthognathic surgery can impact the airway whether or not a patient has OSA, so the changes in the airway must be carefully considered during treatment planning.

Conclusion

Generations of surgeons have focused mainly on the original three pillars of orthognathic surgery treatment planning: dental decompensation and stability, skeletal correction and stability, and a pleasing esthetic outcome. Now there is a fourth pillar of treatment planning: providing skeletal support of the airway and surgical movements that enhance the airway or at least mitigate any deleterious effects.

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