Orthognathic Surgery is a new clinical sub-discipline that emerged in western technologically developed countries in the 1960s and gradually developed and matured in the 1980s. Orthognathic surgery applies surgical and orthodontic means, guided by aesthetic theory, to adjust and reconstruct the maxillofacial bone structure, rebuild the beautiful and effective occlusal relationship, and achieve the purpose of restoring the oral function and improving the beautification of appearance through the transformation of the middle and lower facial structure. The whole treatment process of orthognathic surgery is permeated with aesthetic activities. A brief history of the development of orthognathic surgery and its aesthetic characteristics The use of surgical means to correct jaw deformity has a history of more than 100 years. 1849 Dr. Simon P. Hullihen of Virginia, USA, firstly reported a case of deformity caused by burns, due to the scar contracture in the lower part of the face, which led to the outward turning of the lower lip and the anterior protrusion of the mandible with the open dentition deformity, and the use of the mandibular osteotomy was improved by the way of moving upward and backward. This is the earliest documented maxilloplasty in the modern medical literature.In the latter part of the 19th century, mandibular deformities were reported in the literature, mainly centered around the mandibular body, mandibular ascending and condylar regions. It was not until 1954 that Caldwall and Letterman performed vertical osteotomy of the ascending mandibular branch and in 1956 Robinson changed to oblique osteotomy of the ascending mandibular branch so that the distal bone segment was pushed back and overlapped with the proximal bone segment to correct the mandibular protrusion deformity. This is a great progress in the history of mandibuloplasty. 1957 Obwegeser reported the famous sagittal split osteotomy of mandibular ascending branch for the first time, which made a breakthrough progress in mandibuloplasty, and became the most widely used procedure for correcting mandibular deformity. Maxilloplasty has a later history of development than mandibuloplasty and has progressed more slowly. In 1921, Wassmund reported that the anterior maxillary malocclusion was corrected surgically, and in 1927, transverse osteotomy was used to correct open jaw deformity, but the wing maxillary joint area was not separated, and the effect was achieved by postoperative long term traction, and in 1951, Dingman and Harding separated the wing maxillary joint for the first time in the execution of the LeFort I osteotomy, so as to complete the whole operation in one stage. In recent years, with the development of orthodontic technology, controlled low-pressure anesthesia technology, solid internal fixation technology, and traction osteogenesis technology, orthognathic surgical technology has been perfected day by day, and the reconstructive treatment of maxillofacial deformity has made great progress. Facial contour beauty is the first condition and the most significant sign of human form beauty, which is related to the structure and shape of human facial soft tissue, especially bone tissue. Orthognathic surgery is the discipline of reconstruction and creation of maxillofacial bone tissues. Most of the orthognathic surgeries are performed by intraoral approach, leaving no scar on the face after surgery, which is an aesthetic feature of orthognathic surgery. The principle of combining holistic and individualized orthognathic design is another aesthetic feature. In the analysis of orthognathic surgery design, the laws of formal beauty such as scale, proportion, symmetry, balance, coordination, shape, spatial arrangement and combination are comprehensively applied to produce a good aesthetic effect. Due to the existence of aesthetic tendency and aesthetic difference, different individuals have specific aesthetic requirements of appearance. The surgical design should respect the patient’s hobbies, interests and special psychological needs while conforming to the safety situation, avoiding the measurement of the same absolute aesthetic standard, and carrying out the individualized aesthetic creation on the basis of certain laws. Orthognathic surgery can improve the patient’s facial shape, and this improvement may be unforeseen good, but it is impossible to fundamentally change a person’s image, and the comparison between two people is meaningless, which is the third aesthetic feature of orthognathic surgery. Second, orthognathic surgery on dental aesthetics The shape and arrangement of the teeth will also affect the appearance of the face, according to the geometry of tooth shape, the maxillary incisors of the labial appearance and inverted face close to the shape. The mandibular incisors should not be exposed when the mandible is in the resting jaw position. The incisal edges of the upper incisors are only exposed by 1 to 2 mm, and when smiling, the upper incisors are exposed by about 2/3 of the labial surface and the lower incisors by 1/2. The incisal edges of the lower incisors are only exposed by 1 to 2 mm, and the curvature of the incisal edges of the lower incisors should basically coincide with the inner curve of the lower lip, but the molar teeth should not be exposed. When the lips are naturally closed, the corners of the mouth face the distal mesial portion of the maxillary cuspids or the proximal mesial portion of the first bicuspids. In a normally dentate adult, the angle between the long axis of the upper and lower central incisors should be within 125 ± 7.9° in lateral view. The upper anterior teeth should be slightly tilted forward to cover the lower anterior teeth, but not more than 3mm, and the overdenture should not exceed 1/3 of the labial surface of the lower anterior teeth. these dental aesthetic parameters must be considered from the overall coordination of the face in the clinical application, and should not be simply isolated and emphasize the specificity of a certain organ. The application of perioperative aesthetic principles in orthognathic surgery X-ray cephalometric analysis is mainly done by tracing the anatomical landmarks of the dental, jaw and craniofacial structures on the X-ray positive and lateral cephalometric films, and then measuring and analyzing the angles and lines composed of these points, so as to understand the structural relationship between the dental, jaw and craniofacial soft and hard tissues, and to make quantitative determination of the relationship between the dental, jaw and craniofacial soft and hard tissues. There are dozens of X-ray cephalometric analysis methods, and due to racial differences, each country has established its own racial standards for normal X-ray cephalometric measurements. Orthognathic surgery requires a great deal of detail and precision, which is difficult to determine and accomplish at the time of the procedure. The desired goal can only be achieved through a series of preoperative predictive analysis of the deformity mechanism, surgical style, osteotomy site, distance of bone movement, and the establishment of the dentition relationship as the basis for the success of the surgery. The preoperative X-ray cephalometric analysis and predictive analysis can provide the basis for surgery on the one hand, and at the same time, it can also understand the results of the postoperative orthodontic treatment of dental and maxillofacial deformities on the other hand. The content of prediction analysis includes the determination of surgical style and osteotomy site, the prediction of osteotomy amount and bone movement direction, the prediction of postoperative dentition relationship, and the prediction of soft tissue side appearance. In recent years, with the development of computer technology and related imaging technology, automatic cephalometric system and prediction system for orthognathic surgery have been developed at home and abroad and the software can not only complete the design of diagnosis and treatment by numerical analysis and graphical analysis, but also simulate surgery, which in turn can realize the success of treatment. It can not only complete the design of diagnosis and treatment plan through numerical analysis and graphical analysis, but also simulate the surgery, and then make accurate prediction and estimation of the change of the overall relationship between the dental and maxillofacial structures after the surgery. Model surgery is based on the results of clinical examination, X-ray cephalometric analysis and effect prediction, the dental plaster model transferred to the jaw frame is truncated and put together, and finally a good occlusal relationship between the upper and lower teeth is obtained. Through the model surgery, we can obtain the three-dimensional concept of three-dimensional space, observe the vertical, anterior-posterior, and left-right problems, and make up for the shortcomings of X-ray cephalometric analysis. At the same time, it can be used to guide the surgical osteotomy site, osteotomy amount, and the direction and distance of the movement of dental bone segments. It shows the coordination of upper and lower dental arches and the adjustment method of intermaxillary relationship. Orthognathic surgery in the aesthetic supplement Orthognathic surgery can greatly adjust the relationship between teeth and jaws, but some orthognathic surgery on the appearance of the aesthetics caused by unfavorable impact, for example, the maxillary overall and anterior surgery often caused by the widening of the base of the nose, nostrils flattened, nasal septum curvature, thinning of the upper lip and so on this is due to the extensive peeling, upward shift of the maxilla as well as the postoperative contraction of the local soft tissues for a variety of reasons in order to avoid the occurrence of the above problems, scholars have come up with a new method to avoid the occurrence of the above problems. In order to avoid the occurrence of the above problems, scholars not only improved the osteotomy itself, but also designed the nasal base reset and upper lip reshaping suture to supplement it aesthetically. In order to avoid the problems of lower lip flaring and excessive exposure of lower anterior teeth in anterior mandibular surgery, the chin muscle is sutured when closing the mucoperiosteal incision. In order to make up for facial defects and deficiencies in orthognathic surgery, zygomatic bone reduction gingivoplasty, partial excision of the buccal fat pad, narrowing of the chin, and liposuction of the submandibular and sub-chin areas can be performed at the same time. It is also possible to utilize autologous bone or prosthetic material implanted at the same time, in order to obtain a more favorable facial contour effect. V. Orthognathic surgery and plastic culture Social and cultural development often hides its inevitability in contingency. at the end of the 19th century, the three cultural phenomena of celebrity culture (fan culture brought by movies), psychoanalysis, and plastic surgery appeared at the same time, and they worked with each other to form the plastic culture, which continuously improves the value of the individual’s presentation in the identity of the individual and the society, and it is at the core of the global cultural development. The position of. The star culture brought about by film and television is based on visual effects, and it generates a cultural demand for social identification with the visual image of characters. The “star” is the result of the penetration and expansion of commercialism in the field of culture, a by-product of the rise of the mass culture industry in the 20th century. The emergence and development of the modern consumerist society brought the prosperity of star culture. Popular culture has become a world of stars. Sigmund Freud published the far-reaching “The Interpretation of Dreams” in 1900. This work gave us a way to outline the spiritual composition of individual human beings. Star culture, on the other hand, induces people to emphasize the outer physical composition of the individual. These two cultural phenomena appear simultaneously, establishing a relationship between the physical image of a person and his or her psychological longings: the perversity of the external appearance is a psychological misfortune, and it is the psychological misfortune that is treated by correcting the physical image of a person. In the culture of plastic surgery, plastic surgery directly affects the human image and is the creator of plastic culture. With the development of commercial economy, people’s material life is becoming increasingly rich, the feast of beautiful consumption began to put on the Chinese “table” and gradually popularized, the human pursuit of the impulse of the beauty of the more and more intense, plastic surgery has become the fastest way to generate this capital, has become an effective means of pulling the beauty of consumption. In the culture of plastic surgery, maxillofacial plastic surgery occupies an important position, orthognathic surgery and craniomaxillofacial surgery through the maxillofacial skeleton shaping and reconstruction, to establish the basis of facial beauty, is the basis of the shape of the individual’s social identity. It is the basis of social identity of an individual. The presentation value of human appearance is greatly improved. Limitations of Orthognathic Surgery The main body of orthognathic surgery is the contour change of the lower 1/3 of the face, and the application of the middle 1/3 of the face is mainly based on Le Fort Ⅱ and Ⅲ, as well as zygomatic zygomatic arch surgery to change the breadth of the middle of the face and the protruding degree, but due to the special anatomical structure of the eyes and nose, it is difficult to do the ideal scaling in the three-dimensional direction of the middle 1/3 of the face. In the clinical study of bilateral sagittal osteotomy of the ascending mandibular branch, there was a widening of the mandible, which was contrary to the increasingly popular thinning of the face, and there was uncertainty about the effect on the temporomandibular joint. Although the emergence of distraction osteogenesis has provided a good treatment pathway for severe mandibular hypoplasia, the course of treatment is long and requires secondary surgical treatment, and the main uniaxial distraction has not yet fully resolved the underdevelopment in the three-dimensional direction. Orthognathic surgery is to ensure occlusal function as the first element of the premise of maximizing the facial bone contour remodeling, such as severe first and second gill arch syndrome, cleft lip and palate secondary jaw deformity, etc., must be coupled with the later soft tissue reshaping. In terms of tissue prediction, two-dimensional prediction in the lateral position is widely used at present. Although software development can achieve three-dimensional prediction of hard tissue, the postoperative condition of soft tissue is affected by multiple factors such as surgical method, amount of movement of hard tissue, surgical time, and degree of response of soft tissue, etc., and it is still in the process of debugging and research and development, and has not yet been widely used in the clinic. The development of orthognathic surgery has made great progress in the treatment of maxillofacial deformity in the past 20 years. The development of techniques such as distraction osteogenesis, minimally invasive surgical techniques under the guidance of endoscopy, computers and three-dimensional navigation techniques, etc., has made the surgical procedures more precise and minimally invasive, and has opened up a brand-new field for the development of surgical techniques. Orthognathic surgery and craniomaxillofacial surgery are in the same vein and do not contradict each other. Only plastic surgery knowledge, but no in-depth knowledge of orthognathic surgery, is not a qualified craniomaxillofacial physician, the same only orthognathic surgery knowledge, do not absorb the importance of aesthetic plastic surgery knowledge, can only lag behind the times. In fact, after years of practical development of various disciplines, people gradually realize that a complete plastic treatment of maxillofacial deformity should be an organic combination of plastic surgery, orthognathic surgery and orthodontics. Complementing each other’s strengths and weaknesses and collaborating with each other are crucial to the treatment of this type of disease.