Origins: Craniofacial Osteotomies
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Although orthodontic treatment provides a means of correcting maxillomandibular skeletal discrepancies, it is limited to actively growing children. In nongrowing individuals, surgical intervention has been implemented to circumvent this limitation.

The first surgical procedure for the correction of a craniofacial deformity was reported in 1848, at which time Hullihen successfully performed a partial osteoplastic resection of a prognathic mandible. The subapical osteotomy of the anterior mandible was followed by the removal of a wedge-shaped section of bone from each side of the mandibular body. The anterior segment was then setback into the new position (Hullihen, 1848).

FIG. 2.2.1. Hullihen's partial osteoplastic resection followed by mandibular setback. Copyright © 1848 American Dental Association. Reproduced with permission of ADA Publishing Co., Inc. from Hullihen SP. Case of elongation of the upper jaw and distortion of the face and neck, caused by a burn successfully treated. Am J Dent Science 1848;9(2):157-165.

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