History of the Orthognathic Surgery

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  +Vaibhav Shah

History of the Orthognathic Surgery.

While an exhaustive history is not possible, a brief chronologic history of orthognathic procedures follows.

Mandibular osteotomies

1846 - Hullihan - Anterior mandibular subapical osteotomy and setback

1906 - Blair - Mandibular body osteotomy

1907 - Blair - Horizontal osteotomy of the ramus, external approach

1925 - Limberg - Posterior oblique vertical ramal osteotomy, external approach

1927 - Wassmund - Inverted "L" ramal osteotomy, external approach

1939 - Kazanjian - Beveled horizontal osteotomy of the ramus, extraoral approach

1942 - Schuchardt - Step horizontal osteotomy of the ramus, intraoral approach

1954 - Caldwell and Letterman - Vertical ramal osteotomy, external approach

1955 - Obwegeser - Sagittal split ramal osteotomy

1968 - Caldwell et al - "C" ramal osteotomy

1970 - Hebert, Kent, and Hinds - Intraoral vertical ramal osteotomy

Maxillary osteotomies

1927 - Wassmund - Le Fort I osteotomy with the pterygomaxillary junction left intact; elastic forces used to bring the maxilla forward

1928 - Axhuasen - Segmental osteotomy through the mid palate

1942 - Schuchard - Staged Le Fort I osteotomy, followed by pterygomaxillary separation; external traction used to bring the maxilla forward

1949 - Moore and Ward - Horizontal transection of the pterygoid plate

1965 - Obwegeser - Fully mobilized the maxilla; in a single step brought it into the predicted position

Osseous genioplasty procedures

1942 - Hofer - Horizontal sliding osteotomy of a receding chin (extraoral)

1957 - Trauner and Obwegeser - Intraoral approach to osseous genioplasty[1]

Historically, the ability to reposition the mandible in a stable manner long preceded the ability to reposition the maxilla. As a consequence, many patients underwent only mandibular surgery to correct a primary maxillary deformity. The specialty of orthognathic surgery did not fully develop until Obwegeser demonstrated the possibility of repositioning the maxilla in a stable consistent manner in 1965 and reported simultaneous repositioning of the maxilla and mandible in 1970.