Principles of Orthognathic Treatment Planning

Cephalometric prediction planning for orthognathic surgery has been used for many years, and despite its limitations, is a tried and tested method of planning. This chapter describes the principle aesthetic diagnostic parameters that need to be reassessed preoperatively at the definitive treatment planning clinic, when the preoperative orthodontic treatment has been completed. It is very easy to overcomplicate the treatment planning process. Though the accurate analysis of soft tissue and dentoskeletal relationships is vitally important, the use of the numerical values obtained from such analyses is to enhance the clinician's observation, not to take the place of observation. Trained observation and quantitative analysis are both required. In treatment planning, once the region at fault have been identified, the next step may be termed vectorial analysis, in which the direction of movement of each jaw/subunit is determined, following which the approximate magnitude of the movement required is determined.