Orthognathic Surgery for Secondary Cleft and Craniofacial Deformities

Orthognathic surgery is a critical component of surgical management of craniofacial deformities such as CLP, craniofacial dysostoses, and mandi-bulofacial dysostoses. These operations can correct discrepancy in jaw relationship and malocclusion, relieve airway obstruction, correct facial asymmetry, optimize facial aesthetics, improve speech articulation, improve ability to masticate, and enhance psychological development and social interaction. It is generally performed after completion of growth; however, in selective cases it may be considered earlier to address functional and psychosocial problems. Oral and maxillofacial surgeons who treat these deformities should be part of a craniofacial team to provide interdisciplinary care for the patient. Distraction osteogenesis is a useful technique in the management of severe craniofacial deformities but does not replace conventional orthognathic surgery, which is safe and predictable. Recent advances in three-dimensional imaging and planning tools have made it possible to plan surgery more accurately and predictably.