Orthognathic Surgery for Patients With Implants and Prostheses

Orthognathic surgery is conventionally indicated during craniofacial development to correct dentofacial deformities. Nevertheless, a substantial number of adult patients remain untreated during the optimal therapeutic window and subsequently undergo compensatory measures, including dental extractions, removable dentures, and implant-supported prostheses, without addressing the underlying skeletal discrepancies. In this report, the authors present 5 cases of adult patients who underwent orthognathic surgery to correct maxillomandibular disharmony. Treatment approaches were individualized and included strategies, such as implant removal and repositioning, staged bone reconstruction, decompensated provisional prostheses, and digitally guided surgical planning. In select cases, allogeneic bone grafting and soft tissue considerations were critical to achieving favorable outcomes. These cases underscore the feasibility and efficacy of orthognathic surgery in older patients and highlight the importance of comprehensive interdisciplinary planning, challenge the traditional notion that skeletal correction is limited to younger populations, and offer an alternative paradigm for managing complex dentofacial deformities in previously rehabilitated patients.