Orthognathic surgery: Principles, planning and practice

Orthognathic surgery: principles, planning and practice is a comprehensive, informative source for anyone treating a multiple-discipline patient. The authors comprehensively reviewed the history of orthognathic surgery, citing past contributors in the development of this specialty. This introduction is followed by an evaluation of the various aspects of orthognathic surgical treatment. Chapters 21 through 61 are dedicated to the different surgical procedures and are of interest to the clinical orthodontist. This text should be considered a good orthognathic source for the advanced clinician. As an introductory text, readers will find some sections difficult to follow.

The style of writing is engaging, with various clinicians sharing the wealth of their knowledge. Some chapters are elementary, particularly chapter 12 with regard to orthodontic appliance design, but others are more challenging. An area that is somewhat disjointed and difficult to follow is on pages 202 and 203. It discusses conventional cut-and-paste surgical predictions. An essential element is left out for this prediction technique: the soft tissue profile. In pages 247 through 249, the authors inserted a section that does not fit well.

Overall, the illustrations are good quality. In several areas, the text could have been made more readable if the information of the same patient had been on the same page. Another area of concern is that several intraoral photos show the most terminal tooth with a bond instead of a band placed in preparation for the orthognathic surgical procedure. Generally, this is not considered acceptable, since there are risks of bracket fracture from the terminal tooth and its potential aspiration during the surgical procedure.

The scientific soundness of the text overall is high. The editors recruited many authors to write chapters that reflect their areas of expertise. Each chapter has an exhaustive list of references to support the information that is presented. In some areas, opinions rather than scientific facts are conveyed to the reader. An example of this is in chapter 14. The author stated that, intraoperatively, patients are given steroids and also covered prophylactively for both gram-positive and gram-negative bacteria. In my experience, this is not the case and varies from surgeon to surgeon. The information presented in chapter 16, “Soft tissue effects of orthognathic surgery,” is, in my opinion, deficient. There are many variables to consider when evaluating soft tissue changes, especially for patients from different ethnic backgrounds.

Persons reading this text should be comfortable with the overall management of the orthognathic surgical patient. Other textbooks that address this topic include Modern practice in orthognathic and reconstructive surgery , edited by William H. Bell; Orthognathic surgery: principles and practice (2-volume set), by Jeffery C. Posnick; and Esthetic orthodontics and orthognathic surgery by David M. Sarver.

I recommend this book especially for the experienced clinician. The editors and authors are engaging and present realistic information in the management of these challenging yet rewarding patients. From a clinician’s standpoint, Section 1, chapters 21 through 61, are the most enlightening.

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Dec 19, 2018 | Posted by in Orthodontics | Comments Off on Orthognathic surgery: Principles, planning and practice
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