CHAPTER 88

Orthognathic Surgery

Orthognathic surgery is bony reconstruction of the mandible and/or the maxilla. The procedure can be classified as Le Fort I, Le Fort II, or Le Fort III. Le Fort I is a fracture through the maxilla. Le Fort II is a fracture through the zygomatic arches. Le Fort III is a fracture through the bony orbits of the eye.

Possible instruments and equipment needed for the procedure include small bone instruments, small saws and a drill, arch bars, stainless steel wires, wire cutters, and a mini–fracture fixation system.

A brief description of the procedure follows:

1. A Petri pterygoid retractor is used to retract the cheek and stabilize the jaw.

2. A Weitlaner retractor is used to retract the mucous membrane over the jaw.

3. A Bauer retractor is used to elevate the mandible and stabilize it.

4. A pterygomasseteric stripper is used to remove soft tissue from mandible.

5. Mini screws and plates are used to maintain the placement of the bones.

6. Arch bars with wires are applied to prevent movement of the jaw during healing. The arch bars will be removed at a later time.

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