Evolution of the Surgical Standard Techniques

The correction of mandibular prognathia, first performed by Vilray Blair more than 100 years ago in the United States, was the beginning of dysgnathia surgery (Blair, Cosmos 1906;48:817-820; Surg Gynecol Obstet. 1907;4:67-78; Int J Orthodont 1915;1(8)1:395–432). As early as the beginning of the twentieth century, various surgical procedures were developed for the correction of mandibular malocclusions in the horizontal mandibular body and in the ascending ramus. Between 1914 and 1945 there was no significant progress in dysgnathia surgery, until rapid development began in the 1950s. Both in Central Europe and in the United States, new surgical techniques were introduced into dysgnathia surgery of the mandible, but also for the upper jaw and midface. In 1955, H. Obwegeser initiated a major progress in orthognathic surgery with the bilateral sagittal splitting of the ascending ramus of the lower jaw to treat mandibular prognathism. The surgical method underwent continuous modifications, such as the enlargement of the bone attachment surface and the associated application of the sagittal splitting technique even in cases of mandibular retrognathism. Bone splitting and segment stabilization have also been significantly modified and improved, allowing complete mobilization of the fragments without compromising the supplying soft tissue structures on the one hand and functionally stable osteosynthesis of the segments on the other (Bell et al., Surgical correction of dentofacial deformities Vol. 1-3. Saunders;1980; Bell, J Oral Maxillofac Surg. 2018;76(12):2466-2481; Kashani and Rasmusson, A Textbook of Advanced Oral and Maxillofacial Surgery– Volume 3. IntechOpen;2016).