Patient and Data Acquisition

Physical examination and analysis of the facial soft tissues remain fundamental steps in orthognathic planning. Regardless of whether it is a single-jaw mandibular/maxillary surgery or a bilateral mandibular/bimaxillary surgery, the decision on the surgery to be performed depends on the complete diagnostic picture of the patient. In this chapter, the chronological steps of planning in orthognathic surgery are discussed. The commonly used radiological imaging modalities, their technical background, and clinical indications are briefly evaluated. An accurate orthognathic planning is based on a combination of clinical examination, imaging, and facial analysis. Röentgen imaging commonly used for orthognathic diagnosis and planning includes conventional X-rays or cone beam computed tomography (CBCT). Especially CBCT can reproduce an accurate visualization of the bone structures of the face, but is less accurate in depicting soft tissues. However, soft tissue evaluation and prediction of soft tissue changes after surgery are essential to obtain a satisfying end result for the patient as well as for the surgeon.