Dental Medicine & Dentistry

Orthognathic surgery is gaining more positive response in India over the recent years owing to the increase in awareness to facial esthetics as the priority in undergoing treatment for skeletal malocclusions. Worsening of facial appearance during the period of pre-surgical orthodontics has been the reason for shift towards a surgery, first approach in the management of dentofacial deformities. A universal method for the use of surgery, first process is difficult to adapt as most patients worldwide treated by “surgery first” approach belong to skeletal Class III malocclusion. On the contrary, the Indian population showed diversity in ethnic facial pattern and presented more skeletal Class I and Class II malocclusions. The objective of this paper is to highlight  ifferences in treatment planning and execution of surgical first approach in severe skeletal Class I, Class II and Class III malocclusions and compare them to the conventional orthodontics first approach through ideal clinical scenarios and critically evaluate the early results achieved.