Combined Use of Facial Osteoplasty and Orthognathic Surgery for Treatment of Dentofacial Deformities

Purpose: Orthognathic surgery is an efficient procedure for cosmetic and functional aims. However, when functional improvement is achieved by mandibular or maxillary operations, additional esthetic corrections may be imperative for some patients. This study aims to introduce our primary practice of simultaneous facial bone contouring and orthognathic surgery for esthetic reasons.

Patients and methods: Ten patients with dentofacial deformities as well as a prominent angle, asymmetric deformities, or a high zygoma and zygomatic arch were recruited from West China Hospital of Stomatology, Sichuan University (Chengdu, China), between January 1, 2014, and July 31, 2015. Traditional orthognathic surgical procedures such as bilateral sagittal split osteotomy and Le Fort I osteotomy combined with facial osteoplasty including mandibular angle ostectomy, outer cortex ostectomy of the mandibular angle, and zygoma and zygomatic arch reduction were performed. Radiographs and medical photographs were taken before and after surgery to compare the effectiveness of the combined use of facial osteoplasty and orthognathic surgery.

Results: All patients had an uneventful postoperative recovery, with no signs of infection, jaw displacement, or osteonecrosis. Radiographs taken 1 week after surgery and pictures of the facial profile and occlusion taken 6 months after surgery showed satisfactory esthetic outcomes. All patients were satisfied with the functional and cosmetic results.

Conclusions: This study indicated the clinical feasibility of simultaneous facial bone contouring and orthognathic surgery for the treatment of dentofacial deformities. Simultaneous facial bone contouring seems to be an alternative procedure in addition to conventional orthognathic surgery for cosmetic aims in certain patients.