Orthognathic Surgery: Principles, Planning and Practice

As a service to our readers, Plastic and Reconstructive Surgery® reviews books, DVDs, practice management software, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The Journal actively solicits information in digital format for review. Reviewers are selected on the basis of relevant interest. Reviews are solely the opinion of the reviewer; they are usually published as submitted, with only copy editing. Plastic and Reconstructive Surgery® does not endorse or recommend any review so published. Send books, DVDs, and any other material for consideration to: Arun K. Gosain, M.D., Review Editor, Plastic and Reconstructive Surgery, Brookriver Executive Center, 8150 Brookriver Drive, Suite S-415, Dallas, Texas 75247. Arun K. Gosain, M.D. Review EditorOrthognathic Surgery: Principles, Planning and Practice, by Farhad B. Naini and Daljit S. Gill, is a tome compiled by two London-based orthodontists. The work is comprehensive, touching on nearly every aspect of orthognathic surgery. The volume is grossly organized into two parts (Part I: Principles and Planning; and Part II: Clinical Practice and Techniques), ostensibly the “why” and the “how” of orthognathic surgery. Part 2 is subdivided into thirds—Orthognathic Surgical Planning and Techniques, Adjunctive Surgery, and Orthognathic Surgery, in sections 1, 2, and 3, respectively—covering the cleft patient and orthognathic aspects of craniofacial surgery. The chapters are written by a wide array of contributors, from different backgrounds and persuasions. It is interesting that a book on orthognathic surgery is compiled/edited by two orthodontists, who undoubtedly have great passion for planning, and for managing orthognathic patients, albeit more from the intellectual and nonsurgical vantage. The first-hand surgical perspective is captured, though, with the inclusion of surgical authors from around the world—oral and maxillofacial, craniofacial, and plastic surgeons. The book also covers the planning, orthodontic, psychological, perioperative, and logistic aspects of orthognathic surgery, from contributors with background in those areas. Drawing on the wealth of experience from many authors ensures different perspectives but at times can make the flow and take-home points feel uneven. A consistent “message” or approach is not garnered, but rather a succinct series of different ideas, approaches, and expert opinions are gleaned on reading this work. The content spans the gamut from the history of orthognathic surgery (including a preliminary chapter by Obwegeser), technical and diagnostic considerations, and applications for sleep apnea, to topics less directly related to orthognathic surgery (i.e., deep plane face lift). The breadth of topics is impressive, but the depth of consideration and interconnectivity between concepts (i.e., conventional dentofacial problems, functional and sleep apnea, cleft and craniofacial, and related aesthetic procedures) is less apparent. Interestingly, although “principles, planning, and practice” are part of the title, and to be centrally emphasized, the book does not dedicate focus on current three-dimensional planning concepts, virtual surgical planning, or computer-aided design/computer-aided manufacturing analysis. More traditional model surgery is addressed instead. Similarly, the mandible-first sequence and alternate splint options are not discussed. The cleft and craniofacial section is thin compared with other areas in the book. Facial width and aesthetic bone contouring, often practiced in Asian countries to achieve the so-called V-line, is also not highlighted. However, the book does feature a discussion of the “surgery-first” approach, which represents a progressive and increasingly popular strategy. In addition, there are excellent chapters that hone in on technical details coupled to specific problems and diagnoses. These concepts are well-developed and considered, including a variety of osteotomy types, approaches, and use in one’s day-to-day practice. In summary, this book provides a broad overview of orthognathic surgery, concepts, and applications. It is a worthwhile addition to the library of anyone dealing with facial bone, aesthetic, cleft/craniofacial, and orthognathic surgery.