Abstract
Orthognathic Surgery in Growing Patients: when Early Is the Right Time
The ideal timing of orthognathic surgery has traditionally been guided by the principle of skeletal maturity, aiming to minimize postoperative relapse associated with residual growth. In classical protocols, this often translates into delaying surgery until late adolescence or early adulthood. However, contemporary orthodontics is progressively shifting toward a personalized, patient-centered model of care, where treatment decisions are not dictated solely by biological milestones, but also by the individual’s psychosocial context and overall quality of life (QoL).
Emerging evidence highlights that severe dentofacial deformities exert profound psychosocial burdens, including impaired self-esteem, social withdrawal, and vulnerability to bullying, particularly during adolescence—a sensitive period of identity formation. In these cases, waiting for complete skeletal maturation may prolong suffering, hinder social integration, and negatively affect psychological development. A patient-centered approach therefore justifies the anticipation of surgical intervention once growth is near completion, especially when psychosocial well-being is significantly compromised.
The integration of validated QoL instruments, structured psychological evaluations, and visual treatment simulations provides clinicians with objective tools to assess the psychosocial impact of malocclusion and to balance surgical timing with individual needs. This paradigm shift emphasizes that the “correct time” for orthognathic surgery is not universal, but highly personalized, depending on the interplay between biological readiness, functional demands, and psychosocial health. Ultimately, by prioritizing patient-centered decision-making, orthodontists and surgeons can not only optimize functional and esthetic outcomes, but also enhance long-term psychosocial adaptation and quality of life.
Learning Objectives
After this lecture, you will be able to define the biological and psychosocial factors that influence the ideal timing of orthognathic surgery.
After this lecture, you will be able to evaluate the role of personalized, patient-centered orthodontics in determining when to anticipate surgical intervention.
After this lecture, you will be able to recognize how quality of life, adolescence, and identity formation can justify adjustments in traditional surgical timing protocols
Learning Objectives
After this lecture, you will be able to define the biological and psychosocial factors that influence the ideal timing of orthognathic surgery.
After this lecture, you will be able to evaluate the role of personalized, patient-centered orthodontics in determining when to anticipate surgical intervention.
After this lecture, you will be able to recognize how quality of life, adolescence, and identity formation can justify adjustments in traditional surgical timing protocols