The preconditions in patients to be treated by orthognatic surgery are mostly focussed on malformation of the dental alveolar ridge as well as the deformity of the jaws. In some special cases the deformity of the whole facial skeleton is involved. The majority of cases which were referred from orthodontists or dental practitioners provide an orthognatic surgical treatment driven by functional problems of the stomatognathic system. In our patient group of more than 1750 cases patients more than 50 percent underwent surgery for reasons of functional disturbances. The other group is mostly driven by aesthetic compromises to a facial aesthetic situation.

The technical considerations deliniates miniplate osteosythesis by using ankle screwdriver and positioning plates in almost always of the cases.

In respect to the function of the stomatognathic system correction of the dental alveolar malformation as well as the action of the deficiencies or atrophia of the facial skeleton will obtain a long-term stability of the stomatognathic system.

However, in respect to this outcome we should consider the aesthetic outcome in our therapy protocol as well.

On special examples out of our treated patient group we will present different severe cases in respect to the aesthetic outcome regarding to long-term results more than ten years ( n = 40).

After two or three years the stability will last for the following years. In some of the cases with more than 20 years of observation the change between the first post operative year in comparison to many years is still not obvious.

Conflict of interest: None declared.