Surgical Approach to the Patient with Bimaxillary Protrusion

The patient who has bimaxillary protrusion often is treated using a combination of orthodontics and orthognathic surgery, and the general approach is dental extraction with retraction of the incisors. In certain cases, maxillary excess may be corrected solely with LeFort I osteotomy and setback and without dental extraction or anterior segmental osteotomies. This article discusses (1) treatment evaluation and planning and (2) the specific surgical techniques, primarily anterior segmental osteotomies and the technical details for setback of the LeFort I osteotomized segment (more than 5 mm), as they relate to the surgical approach of the patient who has bimaxillary protrusion.