History of Orthognathic Surgery

Orthognathic surgery, made possible by advancements in anaesthesia, began with Simon P. Hullihen’s pioneering mandibular segmental ostectomy in 1849. Over the decades, figures like Vilray P. Blair, Varaztad Kazanjian, and Paul Berger refined techniques for mandibular prognathism and osteotomies, integrating tools like the Gigli saw. European centres in Berlin and Vienna, led by Martin Wassmund, Richard Trauner, and Hugo Obwegeser, contributed to the development of bilateral split osteotomy. Innovations extended to maxillary surgery, beginning with Bernhard von Langenbeck’s work in 1859 and evolving through Gunther Cohn-Stock’s segmental osteotomy (1921) to Hugo Obwegeser’s complete LeFort I osteotomy (1965). William H. Bell’s research in the 1960s and 1970s confirmed revascularisation, securing the safety of maxillary procedures. Technological advancements, including screw fixation (Hans G. Luhr, 1968), 3D printing, and robotic surgery, have since revolutionised the field. Influential figures like Harold Gillies and Paul Tessier expanded orthognathic surgery into craniofacial reconstruction, shaping modern maxillofacial and craniofacial surgery.