en تخصصي Special گزارش مورد case report <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="text-autospace:none"><span style="vertical-align:middle"><span sans-serif="" style="font-family:Calibri,"><span style="font-size:10.0pt"><span style="line-height:120%"><span minion="" pro="" style="font-family:"><span style="color:black">Orthognathic surgery, a pivotal treatment for patients with significant facial aesthetic and occlusal concerns, traditionally involves a phased approach comprising preoperative orthodontics, surgery, and postoperative orthodontic treatment. However, the extended duration of conventional methods often leads to patient dissatisfaction. In response, the surgery-first approach (SFA) has emerged as an alternative, aiming to streamline treatment and reduce complexity. This case report explores the implementation of the SFA without preoperative orthodontics, focusing on its integration with intermaxillary fixation (IMF) screws. A 25-year-old male presented with severe mandibular retrognathia and facial asymmetry. The radiographic evaluation confirmed the skeletal discrepancy, prompting a surgical solution. Utilizing three-dimensional (3D) planning software, LeFort I osteotomy for maxillary advancement and bilateral sagittal split osteotomy (BSSO) for mandibular setback was planned. IMF screws were strategically placed to stabilize the maxillomandibular complex intraoperatively. Immediate postoperative orthodontic adjustments-initiated dentition alignment and leveling. Regular follow-up ensured treatment progress and stability. The use of IMF screws in the surgery-first approach facilitated precise surgical movements, accelerated treatment timelines, and enhanced patient comfort. This adjunctive technique represents a promising avenue for improving surgical precision and patient outcomes in orthognathic surgery. Further research is warranted to explore the long-term stability and broader applicability of this approach across diverse patient populations. </span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="text-autospace:none"><span style="vertical-align:middle"><span sans-serif="" style="font-family:Calibri,"><span style="font-size:10.0pt"><span style="line-height:120%"><span minion="" pro="" style="font-family:"><span style="color:black"></span></span></span></span></span></span></span></span></span></span> Arch bar, IMF Screw, Orthognathic surgery, Surgery-first-approach 104 110 http://wjps.ir/browse.php?a_code=A-10-466-66&slc_lang=en&sid=1 Ashkan Golabkesh Afshar 100319475328460016223 100319475328460016223 No Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Sahand Samieirad 100319475328460016224 100319475328460016224 No Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Iman Shiezadeh 100319475328460016225 100319475328460016225 No Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Omid Alizadeh 100319475328460016226 100319475328460016226 No Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Amirmohammad Moradpour 100319475328460016227 100319475328460016227 No Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Seyyed Hamidreza Aboutorabzadeh 100319475328460016228 100319475328460016228 No Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Sina Samieirad samieiradsina@gmail.com 100319475328460016229 100319475328460016229 Yes Department of Otolaryngology, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran