Orthognathic surgery for patients with maxillofacial deformities.

Orthognathic surgery is performed to alter the shape of the jaws to improve dental occlusion stability, improve temporomandibular joint function, open the oropharyngeal airway, and improve the patient's facial proportions. Surgery must be coordinated with orthodontic treatment. The surgeon develops a plan based on the patient's measurements and performs the planned procedure on plaster models of the patient's jaw and teeth to obtain the proper jaw position. Surgical techniques include LeFort procedures and distraction osteogenesis. Possible complications of orthognathic procedures include airway compromise, numbness, and nonunion or malunion of the bones. Postoperative instructions include an emphasis on the need for the patient to consume a blended diet for six weeks after surgery.

Distraction osteogenesis in the craniofacial skeleton.

Bone deficiency in the craniofacial skeleton has posed a challenge to craniomaxillofacial surgeons for many decades. Sliding osteotomies and bone grafting have been traditional staples for correcting bone deficiency. In recent years, especially with the advent of newer devices, mechanically induced growth of bone and soft tissue has be-come a major tool in the correction of bony deficiency of the skull and face. In this article, the authors discuss the physiology and technique of distraction osteogenesis, or mechanically induced growth,for the correction of congenital and acquired facial deformities.