Combined maxillary and mandibular osteotomies.

In certain patient categories single-jaw surgery will not result in the optimal outcome that can be achieved through bimaxillary surgery. These include patients with asymmetrical facial deformities (usually mid and lower face), long face deformity with vertical maxillary excess and significant mandibular retrognathism, and bimaxillary protrusion or retrusion. To correct such deformities a well-planned and orchestrated orthodontic preparation followed by bimaxillary orthognathic surgery is necessary. An interim occlusal splint will guide the surgeon in moving the maxilla, and the final splint will position the mandible. Precise attention to detail throughout the operative course is essential to an optimal outcome. Rigid fixation will minimize the need for traditional intermaxillary wiring.