New Perspectives on Maxillofacial Reconstruction in Patients With Skeletal Malocclusion: Deep Integration of Maxillofacial Reconstruction and Orthognathic Surgery Concepts.

The application of computer-assisted design and manufacturing (CAD/CAM) technology and digital guides has made maxillofacial defect reconstruction surgery faster, more convenient, precise, and highly accurate in restoration. However, in addressing maxillofacial reconstruction for patients with skeletal malocclusion, the restoration of facial contours has received less attention, and surgical planning for such cases remains challenging. In this study, we report a case where the deep integration of maxillofacial reconstruction and orthognathic surgery concepts was applied. The patient presented with an ameloblastoma of the mandible along with mandibular prognathism. By utilizing translational and rotational maneuvers of the bone flap, along with appropriate shaping, we replaced the traditional mandibular bilateral sagittal split osteotomy (BSSO), achieving both mandibular reconstruction and the treatment of mandibular prognathism. The postoperative recovery was excellent, with significant improvement in the patient's facial contour, yielding satisfactory results. We believe that incorporating orthognathic surgery principles into maxillofacial reconstruction can effectively balance functional and aesthetic requirements.