Time-Tested Guidelines for Sequencing Orthognathic Surgery

The timing of surgery during the treatment of the orthognathic surgical patient is a very important decision in developing an optimum treatment plan and delivering the best outcome. This has been studied, reported on, and practiced by clinicians for decades. The basic principles of sequencing surgery and orthodontics have been developed and tested over thousands of patients since the 1970’s. A “surgery first,” “orthodontics first,” or “surgery in the middle” approach is never going to be right for every patient. Each individual patient has an optimum time for surgery. Some of the principle criteria for sequencing surgical-orthodontic treatment will be presented in the time allowed.

Learning Objectives:

• Realize the advantages and disadvantages of surgery early or late in treatment of the orthognathic surgical patient.
• Identify patients’ facial morphologic and growth factors influencing timing of surgery.
• Perform biomechanical diagnosis, planning and procedures in the surgical-orthodontic sequence.