Ideal Timing for Orthognathic Surgery: Integrative Literature Review and Analysis of Factors Influencing Postoperative Stability

Abstract

Introduction: Orthognathic surgery is a widely used procedure to correct dentofacial skeletal discrepancies that impair the aesthetics and function of the stomatognathic system. However, defining the ideal timing for its execution remains controversial and is influenced by factors such as the end of craniofacial growth, occlusal stability, bone maturation, and psychosocial aspects. Objective: To perform an integrative literature review on the ideal timing for orthognathic surgery, analyzing the biological, orthodontic, surgical, and psychosocial factors that influence postoperative stability and the predictability of outcomes. Methods: This integrative literature review was conducted using the PubMed, Scopus, LILACS, and Web of Science databases, including articles published between 2015 and 2025, and employing the descriptors “orthognathic surgery,” “timing,” “facial growth,” “skeletal maturity,” “stability,” “relapse,” and their corresponding terms in Portuguese. Results: The studies converge in indicating that the ideal timing occurs after the cessation of facial skeletal growth, generally between 17 and 18 years of age in females and 19 to 21 years in males. Postoperative stability is influenced by the magnitude of skeletal movements, type of osteotomy, fixation technique, and individual factors such as facial pattern and condylar maturation. Conclusion: The ideal timing for orthognathic surgery should be individualized, taking into consideration skeletal maturation, occlusal stability, and psychological conditions of the patient. The use of three-dimensional tools and integrated orthodontic-surgical protocols increases predictability and reduces relapse rates.