Surgical Management of Skeletal Vertical Facial Problems

Orthodontic correction of the extremes of vertical facial proportions is perhaps the most difficult to achieve without the use of orthognathic surgical approaches. Obviously surgery is reserved for the appropriate age groups of these patients, and with the advances made in surgical procedures, more optimal outcomes can be achieved. Orthognathic surgery represents the combination of art and science. In this paper, the subject of maxillary orthognathic will be discussed providing a historical perspective as well as a brief review of the maxillary anatomy. A surgical technique employed by the senior author will be described in some detail in order to provide information on aspects of the “team approach” to patient management. Examples are provided in the sequential surgical procedures for both “long” and “short” facial patients. It is obvious that a close working relationship between an orthodontist and a surgeon is essential in order to obtain the optimal treatment outcomes.