Orthognathic surgery, is often required for patients with rare diseases in order to normalize occlusion that is generally severely affected. There is no one specific surgical approach because anomalies encountered in this population often require various complex technical procedures. Unlike common dental malocclusions, agenesis, skelettal dystrophies and functional problems are gathered. Orthodontic preparation, before surgery, is made difficult, resulting in a challenging treatment process. In certain cases, the stability of the result can be uncertain due to major dysfunctions. However, given the functional as well as morphological improvement that these procedures bring about, they should be planned if the dysmorphia is significant.