Initial situation
- Facial and smile presentation requiring combined surgical and orthodontic correction
The case is presented as a full-face and smile transformation achieved through a staged surgical-orthodontic protocol.
The decision
The case is shown here as a before/after outcome. The treatment plan followed the standard staged sequence for surgical-orthodontic cases: pre-surgical orthodontic preparation, orthognathic surgery, and final bite refinement.
The result
Over a treatment course of about two years, spanning pre-surgical orthodontic preparation, orthognathic surgery, and final bite refinement, a complete transformation of the face and smile was achieved.
Complex skeletal discrepancies that cannot be resolved with orthodontics alone may require a staged surgical-orthodontic protocol to achieve a stable facial and occlusal result.
About skeletal expansion & MARPE
Cases requiring orthognathic surgery follow a staged protocol: pre-surgical orthodontic decompensation, the surgical correction itself, and post-surgical bite refinement. Each stage depends on careful assessment of the skeletal and dental relationships, including transverse coordination between the arches, so that the surgical movement and final occlusion are compatible. This case reflects the general principle that combined surgical-orthodontic planning is reserved for skeletal discrepancies beyond the scope of orthodontics alone.
Questions clinicians ask
Why was orthognathic surgery needed in this case?
The case involved a skeletal discrepancy significant enough to require combined surgical and orthodontic correction rather than orthodontics alone.
What are the main stages of a surgical-orthodontic case?
In cases like this, treatment typically follows pre-surgical orthodontic preparation, the orthognathic surgery itself, and a final phase of bite refinement.
How long did this case take?
The entire process took about two years.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
