Adult orthodontic demands have increased; however, orthodontic and surgical treatments should be applied to elicit optimum therapeutic effects on severe osseous deformity. Orthodontic-orthognathic treatments include three aspects: preoperative orthodontic procedures, orthodontic-orthognathic operation, and postoperative orthodontic procedures. In preoperative orthodontic procedures, the compensation of teeth is removed to improve the coordination of soft tissues and bone tissues. Orthognathic operation is then performed. In postoperative orthodontic procedures, occlusion is further adjusted. This method requires a long time, and patients suffer from psychological and functional effects. Surgery-first approach(SFA) has been proposed to resolve the inconvenience caused by preoperative orthodontic procedures. This article summarizes the basic concepts, clinical applications, advantages, and disadvantages of SFAs.
