Orthognathic surgery is required when the jaws don’t align correctly. Teeth are straightened with orthodontics whereas corrective jaw surgery is required to reposition and properly align the jaw. This helps to improve facial appearance, proper alignment of the jaws and functionality of the teeth.
For those who may suffer from improper bites or jaws that are malpositioned, orthognathic surgery might be a solution. As a child develops, sometimes the upper and lower jaws grow at different rates creating misalignment of jaws. This can affect chewing, speech, long-term oral health, and appearance.
Orthodontic treatment corrects bite problems involving the teeth; however orthognathic surgery will be necessary to resposition the jaw if the misalignment is too severe to be corrected by orthodontic treatment alone.
Certain conditions to evaluate if they persist are:
A team approach consisting of the general dentist, orthodontist, and oral and maxillofacial surgeon is essential to the successful outcome of the surgery. The general dentist will help maintain the health of the teeth and gums. The orthodontist will perform pre-surgical orthodontics to level the arches and align the teeth correctly in each jaw. By removing the dental compensations, the degree of skeletal defect is better realized and the surgical planning can then proceed. A post-surgical orthodontics is still required for final correction of the teeth positions.
Drs. Arzadon, Liang, Blais, and Jacks use the traditional and time proven model surgery using impressions of the teeth and performing mock surgery on the models to plan the surgery. However, three-dimensional imaging using our office CBCT and models as well as other advanced computer techniques to show the patient how the surgery are also performed on specific cases. With comprehensive facial x-rays and computer imaging, you will get an idea of how your facial profile will appear after surgery. Our goal is to explain the potential benefits and familiarize you with the process involved.
Orthognathic surgery is performed in the hospital under full general anesthesia lasting 2-6 hours depending on the complexity of the surgery. After surgery, the patient can be discharged the same day or stay in hospital for 2-3 days depending on the length and complexity of the surgery. The maxilla (upper jaw) is separated then moved as one or more pieces and fixated in the planned position using small titanium screws and plates. The mandible (lower jaw) is split or separated in the back (ramus) then moved forwards or backwards and fixated using titanium screws and plates. The chin is also moved to increase or reduce the prominence and fixated with titanium screws and plates. Bone grafting using the hip, bone removed from the mandibular movement, skull, or bone bank is also done as needed to bridge the bone defects and for cosmetic correction due to skeletal defects.
After the surgery, the jaws are guided with rubber bands placed on the upper and lower braces. However, in rare cases, the jaws may be wired together for up to 6 weeks. The surgical splint is also placed to help guide the teeth in the new jaw positions.