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Orthognathic surgery

Orthognathic surgery is usually implemented to correct severe dentoskeletal discrepancies which cannot be treated with orthodontics alone.


What is Orthognathic Surgery?

Orthognathic surgery (Greek “orthos” means straight and “gnathos” means jaw) is a single or double jaw surgery which is performed to reposition the jaws. During orthognathic surgery a correct jaw alignment and occlusion, as well as, facial harmony is achieved. When the jaws are moved forwards or backwards, up or down, or rotated, the facial soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the jaws are correctly positioned a harmony between the facial features is acquired which results in a beautiful profile.

Previously, all dental and skeletal malocclusions were managed with orthodontic treatment alone in order to achieve the best possible interdental contact, irrespective of the position of the jaws. This method is called “orthodontic camouflage”. Nowadays, a combined of orthodontic and surgical treatment is available as an ideal alternative approach for patients suffering from skeletal malocclusions.



Orthognathic surgery



Mandibular Advancement Mandibular Advancement

When to Orthognathic Surgery?

Patients from ages 18 to 45 years of age are the best candidates for orthognatic surgery. Orthognathic surgery is performed after the age of 18 years when the jaws normally stop growing. Orthognathic surgery is rarely used on children under 18 years of age. Their treatment is limited to orthodontics and growth modification of the jaw, unless orthodontic treatment is not effective due to the severity of skeletal discrepancy. The overall medical state and dentition, rather than the age, is of primary concern when considering orthognathic surgery for the elderly.

 


Benefits of Orthognathic Surgery

Corrective jaw surgery moves your teeth and jaws into positions that are more balanced, functional and healthy. Although the goal of this surgery is to improve your bite and facial esthetics, some patients also experience enhancements to their speech and even sleeping (widening of nasal airway). The results of corrective jaw surgery can have a dramatic and positive effect on many aspects of your life.



Maxillary advancement and Mandibular setback





Mandibular Prognathism

Who Needs Corrective Jaw Surgery?

Corrective jaw surgery is used to treat those patients with discrepancies that are not correctable with conventional orthodontics alone. Your orthodontist and Oral and Maxillofacial Surgeon will work together to determine whether you are a candidate for orthognathic, surgery.  Causitive factors include, but are not limited to, inherited characteristics such as inadequate or excessive developmental skeletal growth of the jaws and bones of the face. Injuries and birth defects may also affect jaw alignment.

 

Following are some of the conditions that may indicate the need for corrective jaw surgery:

  • Severe open bite (space between the upper and lower teeth when the mouth is closed)
  • facial injury or birth defects
  • receding chin
  • protruding jaw
  • inability to make the lips meet without straining
  • severe constriction of upper jaw
  • Too much gummy show during smiling

Mandibular Prognathism





 

What Is Involved in Corrective Jaw Surgery?

Optimal treatment for the surgical case involves a coordinated team effort between your dentist, orthodontist, and oral surgeon. The usual sequence of treatment is as follows:

  • Diagnostic records and treatment planning
  • Pre-surgical orthodontics
  • Surgery
  • Post-surgical orthodontics

 


Treatment Planning

Diagnostic records consist of models of the teeth, radiographs of the jaws and teeth, and photographs. These are reviewed by the orthodontist and the oral surgeon. The team of doctors will develop a treatment plan that provides optimal facial balance and dental stability.



Treatment planning for orthognathic surgery





Digitized lateral cephalogram


Presurgical Orthodontics

Pre-surgical orthodontics involves a comprehensive approach (upper and lower braces) to level and align the teeth in their respective jaws. Because your teeth are being moved into a position that will fit together after surgery, you may at first think your bite is getting worse rather than better. When your Oral and Maxillofacial Surgeon repositions your jaws during surgery, however, your teeth should fit together properly. This may take 9-15 months.

As your pre-surgical orthodontic treatment nears completion, additional or updated records, including x-rays, pictures and models of your teeth, may be taken to help guide your surgery.

 


Surgery

Surgery will be scheduled, once the teeth are in their proper pre-surgical positions. The surgery is performed in the hospital under general anesthesia. It may take from one to several hours to complete and the typical stay is two days and one night. The surgical procedure is performed with the braces on the teeth so the surgeon may attach elastics or other anchorage type devices for post-surgical stability.



Orthognathic surgery




Post surgical recovery



After surgery, your surgeon will provide instructions for a modified diet, which may include solids and liquids, as well as a schedule for transitioning to a normal diet. You may also be asked to refrain from using tobacco products and avoid strenuous physical activity.

Pain following corrective jaw surgery is easily controlled with medication and patients are generally able to return to work or school from one to three weeks after surgery, depending on how they are feeling. While the initial healing phase is about six weeks, complete healing of the jaws takes between nine and 12 months.



Post Surgical Orthodontics

After approximately 1-2 months of jaw healing, post-surgical orthodontics is used to detail the positions of the teeth and finalize the bite. This usually takes 6-9 months. Once complete, the braces are removed and retainers are placed.


post surgical orthodontics  




   prediction of orthognathic surgeryprediction of orthognathic surgery 

New Approches

Using the latest in digital imaging technology, we will demonstrate the overall functional and aesthetic benefits of orthognathic surgery. Computerized treatment planning minimizes treatment times and maximizes the overall efficacy of your surgery. State-of-the-art materials such as titanium plates and miniature screws provide stability, strength and predictability to your treatment. These advances in technology, procedures and equipment reduce post-surgical recovery time, thus allowing patients to return to their normal routines soon after the surgery.

 


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