Achieving ideal results when treating a difficult malocclusion is a challenge that orthodontists frequently encounter. Maintaining those results is sometimes more challenging than the correction itself. As specialists in orthodontics, we should be able to apply bone physiology concepts during the diagnosis and treatment planning process and predict how bone will react after biomechanical stimuli. Understanding bone physiology and the biology of tissue response during orthodontic tooth movement should allow us to develop the proper mechanical design and consequently the therapeutic procedures necessary to achieve the expected tooth position and bone architecture. Surgically facilitated orthodontic therapy uses basic bone biology and physiologic bone turnover procedures as well as basic orthodontic biomechanical principles to correct dental malocclusions in the shortest, safest, and most conservative manner. The correction of such malocclusions with this approach is expected to be functional and stable.