The Treatment of Skeletal Facial Deformities Using Virtual 3-D Planning and a Surgery First Protocol

Orthognathic surgery is used to correct skeletal facial deformities (SFD), and malocclusion, in patients for whom orthodontic treatment is insufficient to achieve the desired results. Regardless of the surgical plan, orthognathic surgery is a collaborative approach, and requires the coordination of a surgeon and orthodontist to ensure the best possible outcome for the patient. Unlike traditional orthognathic surgery, a surgery-first approach, forgoes pre-surgical orthodontics and instead relies on orthodontic treatment only after surgery is complete. With this technique, major orthodontic movements can be made in a reduced period of time, taking advantage of the accelerated post-operative tooth movement shortening the duration of treatment needed to achieve the desired results and sparing the patient months of discomfort and social stigma from orthodontic braces. At the University of Connecticut the Divisions of Orthodontics and OMFS have been treating SFDs using a combination of virtual 3-D planning and a surgery first protocol for several years. Our treatment protocol and specific cases with outcomes will be presented along with data demonstrating the effect on overall treatment time and intraoperative measures such as blood loss, surgical time and operative complications. Particular attention will be given to the treatment of skeletal asymmetries using this technique.