Sometimes the patient needs surgery in addition to orthodontics. The need for surgery depends on several factors, one of which is that patients who have had a growth spurt for some time and have orthodontic problems need surgery, for example, the lower jaw of a 30-year-old patient cannot be moved backward using Chincap. The next issue is the patient’s genetic factors. When the mandibular protrusion is inherited in the family. With orthodontics alone, we do not succeed in treatment. In addition to orthodontics, the patient also needs surgery, and the third factor is that surgery is required when the seriousness of the problem is high. Sometimes the degree of the problem is low, for example, we treat mild Cl III with Chincap, but in Cl III, with Reverse Overjet 10 mm, surgery and orthodontics must be done together. The type of surgery depends on the type of deformity depending on the shape of the face, and the patient’s growth should be complete. For example, at age 17 or 18, when growth has stopped, surgery can be done.
Therefore, in patients with orthodontic problems to the extent that the problem cannot be resolved by change of growth or camouflage, displacement of the jaw or parts of the alveolar partitions will be the only possible treatment. In these patients, surgery does not replace orthodontics, but orthodontics or other dental treatments provide the conditions for achieving good results with surgery. The treatment of mandibular protrusion with surgery began in the early 20th century, and regarding patients treated with surgery, Edward Engel points out that if these patients are treated with orthodontics and Splint occlusal after surgery, better results will be obtained. The discovery of the sagittal osteotomy in 1959 by Obwegeser and Trainer ushered in a new era in orthognathic surgery. This surgery is performed through the mouth, and skin scars that can move the lower jaw forward or backward can also be addressed. In cases of mandibular deviation, this surgical method can rotate the mandible to correct the deviation. Therefore, this surgical method is effective in moving the jaw forward and backward and in treating mandibular deviation.
