American Board of Orthodontics (ABO) Practice Exam

In the context of combined skeletal advancement and pharyngeal soft tissue surgeries, performing skeletal advancement first is crucial for a few reasons.

When skeletal advancement, often through procedures like maxillary or mandibular osteotomy, is carried out prior to soft tissue surgery, it allows for better visualization and access to the pharyngeal region. This order helps in achieving appropriate skeletal positioning, which then allows the soft tissue components to be tailored effectively to the new skeletal framework.

Moreover, advancing the skeletal structures before addressing the soft tissues can lead to more predictable outcomes in airway enhancement and functionality. By establishing the desired skeletal alignment first, the surgeon can then modify the adjacent soft tissues appropriately, optimizing the airway and reducing the likelihood of postoperative complications related to the soft tissues being altered without the context of the skeletal changes.

Simultaneous procedures may introduce complexity, making it harder to assess the soft tissue response to the skeletal adjustments, and going for nonsurgical options does not address cases where surgical intervention is clearly indicated. Hence, the sequence of performing skeletal advancement first is considered best practice in achieving optimal results in combined procedures.