Evolution of Orthognathic Surgery

In this chapter, the evolution of orthognathic surgery is traced in the context of five publications that highlight key events in the development of contemporary techniques to address skeletal malocclusions related to developmental or congenital conditions. While the articles highlighted here may be considered seminal in context, there are other contemporaneous works that have shaped current practice as well. These five articles should be considered anchors for the following critical events that remain relevant to current practice: (1) development of the sagittal osteotomy of the mandibular ramus, (2) understanding of the biologic basis for the Le Fort I osteotomy, (3) basic principles for facial analysis as applied to dentofacial deformities, (4) stability of jaw positioning as a function of specific movements (with subsequent modification to account for rigid fixation), and (5) development of computer-assisted three-dimensional surgical planning.