Surgery-first Approach

Abstract

ABSTRACT Aim This article is intended to provide an overview of the Surgery First Approach (SFA) mainly including case selection, diagnosis, treatment protocols, success rate and the potential problems encountered. Background The most important indication of the need for orthognathic surgery is usually the psychosocial effect resulting from the unaesthetic appearance of a dentofacial deformity. The conventional approach in treatment of such deformities till today has been an orthodontics-first approach. Review Results Available evidence suggest that both the SFA and the conventional approach had similar outcomes in dentofacial relationships however the relapse tendency was greater with the SFA but the total treatment duration was substantially shorter. Conclusion SFA treats facial aesthetics (and the skeletal malrelation) first and then occlusion, i.e. orthognathic surgery antecedes the orthodontic therapy. The concept of this technique is to utilize orthognathic surgery to eliminate the displeasing pre-surgical facial profile and promptly accomplish facial aesthetic enhancement that is usually the patient's chief complaint at the beginning of the treatment. SFA also facilitates accelerated orthodontic tooth movement thus reducing the length of post-surgical orthodontic therapy. Clinical Significance The optimal esthetic and functional results, significant reduction in total treatment time and high patient satisfaction led us to the postulation that SFA may represent a reasonable, cost-effective method to manage skeletal malocclusions in selected cases and that it has the potential to become a standard approach to orthognathic surgery in the future. How to cite this article Shah YA, Deshmukh SV, Patil AS. Surgery-first Approach. World J Dent 2017;8(4):343-350.