**1. Introduction**

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The development of orthognathic surgery techniques and materials has allowed surgeons and orthodontists to standardize treatment of maxillomandibular deformities. Multidisciplinary treatment of skeletal deformities by orthognathic surgery in addition to orthodontics has become a routine strategy believed to result in functional and esthetic outcomes in adult patients.

When malocclusion is caused by severe skeletal discrepancies, the orthodontist can propose dentofacial orthopedics in growing children, dental compensation for skeletal deformity or orthognathic surgery combined with orthodontic treatment (when the major growth potential of the patient has been completed). The decision is based on clinical examination and cepha‐ lometric analysis, both of which aim to assess the amount of three dimensional discrepancy. Patients with functional and esthetic issues require a multidisciplinary approach involving orthodontic and orthognathic surgery to reposition the maxilla and/or the mandible in three dimensions. Such a therapeutic approach is considered as the best treatment; it corrects dentofacial deformities which cannot be treated by orthodontics alone [1].

The stability of results in addition to the functional well-being and aesthetic appearance approach the level of excellence. The issue of skeletal, dento-alveolar and soft tissue relapse is a matter of discussion, debate and controversy in the orthodontic literature. The aim of this chapter is to define the criteria for stability that must be complied during both preparatory orthodontic and surgery phases in orthognathic surgery, without over-timing the postopera‐ tive orthodontic phase.

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#### **1.1. Stability criteria of ortho-surgical treatment** sustainable interventions. Three treatment objectives, which form the basis in

The management of dento-skeletal dysmorphosis requires a team of specialists that mainly include orthodontists and maxillofacial surgeons. The ultimate aim of orthodontists is both to meet the patients' expectations, and make effective sustainable interventions. Three treatment objectives, which form the basis in treating patients with dento-facial deformities, are funda‐ mental in orthognathic surgery namely function, esthetics, and stability. Skeletal relapse is the most common complication following orthognathic surgery. Optimal treatment planning for maxillofacial surgery requires an understanding of postoperative skeletal stability, dentoalveolar position and the soft tissue response to skeletal movement. Accurate treatment planning and careful orthodontic and surgical protocols are essential to the achievement of treatment objectives; these have to be planned with collaborating partners upon initial consultation (Figure 1). [1] treating patients with dento‐facial deformities, are fundamental in orthognathic surgery namely function, esthetics, and stability. Skeletal relapse is the most common complication following orthognathic surgery. Optimal treatment planning for maxillofacial surgery requires an understanding of postoperative skeletal stability, dento‐alveolar position and the soft tissue response to skeletal movement. Accurate treatment planning and careful orthodontic and surgical protocols are essential to the achievement of treatment objectives; these have to be planned with collaborating partners upon initial consultation (**Figure 1**). [1]

**MEDICAL‐EDITED CHAPTER FOR AOMFS VOL 2**

The management of dento‐skeletal dysmorphosis requires a team of specialists that

orthodontists is both to meet the patients' expectations, and make effective

**Figure 1.** Factors influencing stability in orthognthic surgery treatment.[1]
