Orthognathic camouflage

Introduction

Some patients may present with a skeletal facial anomaly that would ideally be treated with orthognathic surgery but do not wish to undergo jaw surgery. In these cases, orthognathic camouflage procedures may be offered as an alternative option. Orthognathic camouflage refers to the use of procedures other than traditional orthognathic surgery to correct facial dysmorphology created by an underlying skeletal discrepancy. Potential indications for a camouflage procedure include a dentally compensated skeletal discrepancy, hemifacial microsomia, posttraumatic jaw deformity, and iatrogenic deformity resulting from previous surgery.

The most common indication for a camouflage procedure is an underlying skeletal malocclusion that has been treated with dental compensation. Dental compensation can be used to treat class II or III malocclusions without surgery in many cases. However, to make room to align teeth in a class I position, other teeth may need to be extracted. It is important to speak with every patient about the underlying etiology of his or her concern (jaw imbalance) and present orthognathic surgery as an option. Additionally, every patient should be questioned about snoring to find out if there is evidence of sleep apnea. If a full sleep assessment reveals underlying obstructive sleep apnea, the correction of the apnea is an important consideration in developing an optimal treatment plan.