# Optimizing Maxillomandibular Position in Orthognathic Surgery: Introducing the T Concept in Treatment Planning

## TL;DR

This paper introduces a new method for planning jaw surgery by using a T-shaped landmark system to improve alignment and avoid complications.

## Contribution

The novel contribution is the introduction of the T concept for holistic maxillomandibular complex surgical planning.

## Key findings

- The T concept offers a structured approach to correct deformities in multiple phases.
- It helps integrate facial structures into harmony and reduces compensatory procedures.
- The method was illustrated through a case of skeletal class III malocclusion.

## Abstract

Background: Orthognathic surgery aims to align the jaws with the facial skeleton and correct dental occlusion. This paper introduces the concept of planning the maxillomandibular complex (MMC) as a whole, utilizing a t-forming set of landmarks: the maxillary central incisor, the chin, and the occlusal plane. Methods: The background, hypothesis, and rationale of the new T concept are explained. A case of a 28-year-old male with skeletal class III malocclusion and an open bite was used to illustrate the application of the T concept in step-by-step surgical planning. The planning encompasses four phases: Phase One involves correcting frontal deformity and various asymmetries, Phase Two involves correcting chin anterior–posterior deformity, Phase Three involves correcting anterior–posterior and vertical MMC position, and Phase Four involves correcting MMC rotation. Results: The T concept provided a structured approach to plan MMC as a whole and integrate all structures into harmony. Conclusions: The T concept provides a logical approach to MMC positioning in orthognathic surgery, addressing functional and aesthetic concerns. It acts as a checkpoint to verify MMC position, helping surgeons achieve better results and avoid compensatory procedures.