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The human face should be in perfect harmony and balance along with
ideal functioning of the stomatognathic system... was a view
idealised by Apollo Belvedere, who created the neoclassical Greek
sculpture of the head and face. However, Nature ensures that all of
us are not blessed with perfect faces. It is for the resolution of
these imperfections that orthodontic treatment is sought. But for
patients whose problems are so severe that neither growth nor
camouflage offers an ideal solution, surgical realignment of jaws
or repositioning of dentoalveolar segments is the only choice.
Surgery is not a substitute for orthodontics in these patients;
instead, it must be properly coordinated with orthodontics and
other dental treatment to achieve overall positive results. With
recent advances in surgical technology, it is now possible to treat
these patients successfully for whom orthodontic camouflage would
have resulted in esthetically unacceptable and often unstable
results. This art and science of diagnosis, treatment planning, and
execution of treatment of dentofacial deformities by combining
orthodontics, oral and maxillofacial surgery to correct severe
musculoskeletal, dento-osseous, and soft tissue deformities of the
jaws and associated structures is called orthognathic surgery.
Successful orthognathic surgery demands the understanding and
cooperation of the oral and maxillofacial surgeon, orthodontist,
and general dentist. Each must provide a proper diagnosis and
treatment plan, perform necessary treatment and refer to necessary
treatment outside his or her respective area of expertise. In order
for patients to receive state-of-art care when correcting their
deformities, the orthognathic team must: 1. recognise the various
characteristics of malocclusion and dento-facial deformity; 2.
define the nature of the problem, including the possible etiology;
and 3. design a treatment strategy based on the specific needs and
desires of the individual. In this modern era, the role of the
doctor has shifted from that of sole decision maker in the planning
process to that of a partner with the patient as co-decision-maker.
Therefore, the clinician must not overlook the importance of
including the patient and parents in the treatment planning
process. Ackermann and Proffit have suggested that clinicians are
generally more influenced by objective findings (problem list) and
patients are more influenced by subjective findings (their
perception of their needs and values). This dichotomy makes
communication an effective tool when one is faced with the decision
between orthodontic camouflage and surgical orthodontic correction.
The authors' of this book examine the diagnosis and treatment
planning in orthognathic surgery.
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