Bone Grafting Strategies and Techniques For Complex Orthognathic Surgery

Abstract: Bone grafting has been a pivotal adjunct in orthognathic surgery, particularly in cases involving large skeletal movements or anatomical deficiencies. This lecture examines the rationale, methodologies, and results related to bone grafting in maxillofacial osteotomies, not only in Cleft craniofacial patients undergoing orthognathic surgery, but also in cases requiring unconventional osteotomies, such as inverted L osteotomies, vertical ramus osteotomy, and conventional osteotomies with large movements, like in Maxillo-Mandibular advancements to treat Obstructive Sleep Apnea. We will review the current literature and create a framework for attendees about indications, graft selection, surgical techniques, integrating bone grafting into the Orthognathic digital workflow, and the effect of bone grafting on long-term results and stability.

Learning Objectives:
1). Identify clinical indications for bone grafting in complex orthognathic procedures, including cases involving cleft craniofacial anomalies, large skeletal movements, and obstructive sleep apnea.
2). Compare and contrast various bone grafting techniques and materials used in maxillofacial osteotomies, including their integration into digital surgical workflows and their impact on long-term skeletal stability.
3). Evaluate the outcomes and evidence-based rationale for incorporating bone grafting in unconventional osteotomies such as inverted L and vertical ramus osteotomies, with a focus on optimizing surgical planning and patient-specific treatment strategies.