Optimizing Facial Esthetic Outcomes: Adding Distraction Osteogenesis to Your Classic Orthognathic Surgery Armamentarium.

Classical orthognathic procedures have long been known to improve the facial esthetic contours and proportions of face by restoring the skeletal foundation, on which the soft-tissue drapes. Distraction osteogenesis was introduced to solve complex skeletal abnormalities in patients with craniofacial conditions that could not be solved by classical orthognathic surgery techniques. The gradual expansion in this group of patients showed not only greater skeletal stability, but the expansion at various tissue planes improved the facial appearance. In this report we review our experience in 22 cases with dentofacial skeletal abnormities for whom we believe achieved aesthetic outcomes could not habe been with classical orthognathic techniques alone. In addition, distraction at the interdental regions allowed for "tailoring" of the osteotomies and for simultaneous expansion at the occlusal level.