surgery first approach
The general formula in traditional orthognathic treatment has consisted of a variable length of preoperative orthodontic preparation, surgery itself, and a relatively constant period of postoperative orthodontics. Recently, orthognathic surgery without presurgical orthodontic treatment (the surgery-first approach [SFA]) has been favored and performed with good clinical outcomes from a precise orthodontic and surgical treatment planning. The advantages of this surgical approach include a total treatment time reduction and psychological benefit from a limited duration of unesthetic orthodontic appliances. Also, more effective postoperative orthodontic movement of the dentition can be achieved through a regional acceleratory phenomenon (RAP).
Under most circumstances, patients being treated with surgery-first accelerated surgical orthodontics require less time in orthodontic treatment than those undergoing the conventional approach. This could be because:
1) The dental decompensation in the surgery first approach is resolved partly by surgery so that the complexity of orthodontic treatment is lesser .
2) The phenomenon of postoperatively accelerated orthodontic tooth movement shortens the treatment period.