The Role of Orthodontics, Orthognathic Surgery and Adjunct Surgical Procedures in the Esthetic Rehabilitation of the Face and Smile: Potential and Limitations

Abstract

For nearly a century, orthodontists have mainly focused on occlusion as the primary objective of orthodontic therapy. The introduction of the soft tissue paradigm has shifted treatment planning from hard tissue to soft tissue and reinforced the key role of facial esthetics in orthodontic diagnosis and treatment planning. Whereas occlusion is rooted in measurable definitions of Class I and other “keys to occlusion”, esthetics is more subjective, based not only on the orthodontist's assessment but also on personal and cultural preferences rather than rigid norms. The aim in this paper is to demonstrate that orthognathic surgery potentially narrows the gap between esthetics and function, even though surgery may have its own limitations. Three reports are presented on patients whose clinical examination, records evaluation and treatment planning have focused on facial and smile esthetics, and treatment approaches that combined orthodontics, orthognathic surgery and appropriate adjunct procedures to enhance the overall esthetic outcome.