Integrating aligners with surgery first: A novel case report on single-jaw, multi-segmented maxillary osteotomy

Abstract

Technological advancements have made the integration of clear aligner therapy (CAT) with orthognathic surgery a reality. This case report outlines an innovative, patient-specific workflow that merges CAT with the surgery first orthognathic approach (SFOA), developed in collaboration with engineers to facilitate in-house production of surgical guides and pre-adapted titanium plates. Objective evaluation was performed using the peer assessment rating (PAR) index. The patient achieved the intended occlusal relationship without discomfort in the temporomandibular joint (TMJ) and experienced no surgical complications. The surgical and occlusal outcomes have remained stable with reduced scores in the PAR index, reflecting improved objective assessment post treatment. This case report is the first of its kind to describe a single-jaw, multi-segmented maxillary osteotomy in SFOA using CAT. It demonstrates precise individualized planning in a multidisciplinary approach integrating CAT with SFOA making it feasible in cases involving a single jaw segmented Le Fort 1 osteotomy.