The indication for surgical-orthodontic treatment is a skeletal or dentoalveolar deformity so severe that the magnitude of the problem lies outside the envelope of possible correction by orthodontics alone. For adults, this means that satisfactory correction by tooth movement is not possible; for children, it means that the problem cannot be corrected satisfactorily by a combination of tooth movement and growth modification. Correction of the dental occlusion is not an adequate description of successful treatment; satisfactory facial esthetics must also result. Extrapolation from existing data for malocclusion in the United States suggests that there are a total of 1.2 million individuals in the present population with problems severe enough to require surgical-orthodontic treatment for satisfactory correction. Of these, 700,000 have Class II malocclusions and 300,000 have Class III malocclusions. Approximately 220,000 individuals have long-face problems.
Orthognathic surgery is typically performed by oral and maxillofacial surgeon or a craniofacial surgeon, with an orthodontist assisting. Pre-surgical orthodontic phase typically requires 6 to 12 months while post-surgical orthodontic phase takes approximately another 6-12months. The purpose of Orthognathic surgery is to ensure that the necessary structure exists in the mouth so that the orthodontic treatment will be successful. Orthognathic surgery usually involves the jaw bones, where modifications are done by cutting the bones of the mandible or maxilla and putting them back together properly aligned. The surgery is performed under general anesthetic and the teeth are wired together after surgery so the jaw can heal correctly. Usually, the incisions are made inside the mouth and not in the skin.