3 The Initial Assessment and Planning by the Surgeon and Orthodontist
The planning of the surgical reconstruction is based on:
1. Clinical exam
2. 2D and 3D Photographs
3. 2D and 3D X-Rays that show the facial skeleton and teeth
4. Digital Scan or Stone casts of the teeth (dental models)
These are analyzed by the surgeon and the orthodontist and an overall surgical and orthodontic treatment plan is developed. The timing of the surgery is based on skeletal maturity. Ideally we would like the jaw bones to have either stopped growing or there is very little growth left. For most girls this means typically not before 15 years of age and for most boys typically not before 17 years of age. Occasionally surgery is done earlier with the understanding that future growth of the jaws may occur and surgery is likely to be repeated. Occasionally surgery is delayed because of continued growth, especially in boys. Overlaying facial x-rays taken every 6 months by the orthodontist will show the amount of continued growth left in the jaws and will help estimate the timing of surgery.