Orthognathic surgery is sometimes called “Surgical Orthodontics” because, just as an orthodontist repositions the teeth, with orthognathic surgery the jaws are placed in their normal anatomic position. Just as “orthodontics” means “straight teeth,” “orthognathic” means “straight jaws.” In fact, because moving the jaws also moves the teeth, orthognathic surgery is usually performed in conjunction with orthodontics so that the teeth are in proper position after surgery. The objective of orthognathic surgery is the correction of a wide range of minor and major facial and jaw irregularities. The benefits include an improved ability to chew, speak and breathe. In many cases, an enhanced appearance can also result.
The unequal growth of the jaws, injury or birth defects can produce problems and symptoms that require treatment by a team that usually includes an oral and maxillofacial surgeon, an orthodontist, and sometimes your dentist. In order to determine if you are a candidate for orthognathic surgery, an evaluation of your condition by this team is necessary.
In diagnosing your need for orthognathic surgery, the surgeon and the orthodontist will work closely together. The orthodontist is responsible for moving the teeth so they will fit together properly after the jaws have been repositioned, and the surgeon is responsible for repositioning the jaw(s) so the teeth and jaws are in proper alignment.
People who can potentially benefit from orthognathic surgery include those with an improper bite and those with jaws that are positioned incorrectly. Jaw growth is a slow and gradual process, and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health, and appearance. Injury to the jaws and birth defects can also affect jaw alignment. While orthodontics alone can correct many “bite” problems if only the teeth are involved, orthognathic surgery may be required if the jaws also need repositioning.
Orthognathic surgical procedures last anywhere from one to several hours, depending on the amount and type of surgery needed. In lower jaw surgery the rear portion of the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as appropriate. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated into several parts, with bone added or removed to achieve the proper alignment and stability. Other facial bones that contribute to the imbalance may also be repositioned, augmented, or reduced in size. In most cases, incisions are made inside the mouth and there will be no visible external scars.
Immediately after surgery, you will be moved to the recovery room until the general anesthesia has worn off. An intravenous apparatus attached to your arm can provide required medications and nutrients until you are able to take sufficient liquids by mouth. To aid in healing, your jaws may be prevented from moving with the use of fixation appliances. In many cases, the jaw sections are held together during the healing period by small screws placed by the surgeon. In other cases, wires are used to hold the bones together and keep the jaws from moving. The initial healing phase will take approximately 6 weeks, but completion of the healing process will take 9-12 months. During the entire healing phase it is critical that you practice the best possible oral hygiene. Your surgeon and orthodontist can assist you in this area and may recommend the use of some special oral care devices.
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Orthognathic surgery moves your teeth and jaws into a new position that is more balanced, functional and healthy. Not only should you be able to bite and chew better than ever before, but your appearance and speech may be enhanced as well. The results of orthognathic surgery can have a dramatic and positive effect on many aspects of your life.