Surgery-First Approach: A Boon for Periodontally Compromised Patients - A Case Report

THE RATIONALE: The surgery-first approach (SFA) has revolutionized orthognathic surgery in recent years and in trend because it addresses the dentofacial abnormalities first, making the patient compliant and outcome more predictable. PATIENT CONCERNS: A 22-year-old female was concerned about her forwardly placed teeth. DIAGNOSIS: She had a compromised periodontium with a skeletal Class II malocclusion and dental malocclusion. TREATMENT: A SFA plan was executed with the extraction of all first premolars followed by postsurgical orthodontic treatment. OUTCOMES: Optimal functional and dentofacial esthetics were achieved by 11 months. TAKE-AWAY LESSONS: Research has attributed several advantages of SFA over the conventional triphasic approach, which has proven to be beneficial in periodontally compromised individuals as it intends to relieve any traumatic occlusion primarily by stabilizing tissue integrity. It is most favorable in patients seeking a quick transformation with the least possible duration.