Corrective Jaw Surgery / Orthognathic Surgery
Corrective jaw surgery and orthognathic surgery (ortho – to move, gnathic – the jaws) are interchangeable terms. Surgery to correct the size and shape of the jaws is a relatively common procedure, often done in conjunction with orthodontics which is required to align the teeth. The maxilla (upper jaw), the mandible (lower jaw) or both jaws may require surgical correction to treat jaw deformities resulting from either developmental problems or following severe trauma. Orthognathic surgery not only improves facial appearance, but also ensures the teeth meet correctly and function properly.
Who Needs Orthognathic Surgery?
People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a 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. Injuries to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved but orthognathic surgery may be required for the jaws when they require repositioning.
Difficulty in the Following Areas Should be Evaluated:
- difficulty in chewing, biting or swallowing.
- speech problems.
- chronic jaw or TMJ pain.
- open bite.
- protruding jaw.
- breathing problems.
Any of these can exist at birth or may be acquired after birth as a result of hereditary or environmental influences or as a result of trauma to the face. Before any treatment begins, a number of consultations will be required to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your surgical and orthodontic team will make the decision to proceed with treatment together.
Technology & Orthognathic Surgery
Dr. Bowler uses modern computer-aided techniques, dental models and three-dimensional biomodels to show you exactly how your surgery will be approached. Using comprehensive facial x-rays and computer imaging, we can show you how your bite will be improved and even give you an idea of how you’ll look after surgery. This helps you understand the surgical process and the extent of the proposed treatment.
If you are a candidate for corrective jaw surgery, Dr. Bowler will work closely with your orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.
It is rare to wire the jaws together these days due to the use of modern rigid internal fixation (bone plates and screws). These devices are used to hold the jaw fragments in their new position. Quite often elastic traction may be used in conjunction with an occlusal wafer to guide the teeth into their new position during the first 6-8 weeks whilst the bones heal.
Some typical case studies are included below to give you an idea as to how the combination of surgery and orthodontics works:
Case Study #1
“This patient presented with crowding, a mandibular deficiency and an anterior open bite and was treated with a combination of orthodontics and orthognathic surgery incorporating bimaxillary surgery and a genioplasty”.
Case Study #2
“This patient presented with crowding and a severe mandibular excess and maxillary deficiency. She underwent orthodontic alignment and leveling and then had a bimaxillary osteotomy with a genioplasty carried out to correct her dento-facial problem”
Case Study #3
“This patient presented with a left sided hemifacial microsomia incorporating a facial asymmetry and a very small mandibular condyle. She was treated with a combination of orthodontic alignment and bimaxillary surgery including a custom left sided TMJ total joint replacement.”
Case Study #4
“This patient presented with probable “burnt out” Juvenile Rheumatoid Arthritis causing destruction of both TMJ’s and an associated dentofacial deformity. She underwent orthodontic alignment followed by surgery involving bilateral TMJ custom total joint replacements, a maxillary osteotomy and a genioplasty.”
What to Expect
- Corrective jaw surgery is a significant intervention requiring many months of orthodontic preparation.
- The surgery is performed in hospital and can last between three and six hours.
- Bone grafting techniques may be a part of the procedure.
- TMJ total joint replacements may occasionally be a part of the procedure.
- Hospital stays of two to three days are normal.
- Braces are maintained during surgery and may not be be removed six to twelve months after surgery.
- The greatest impact of orthognathic surgery is the recovery phase.
- Patients typically may be off work/school from two weeks to one month after surgery.
- Return to normal chewing function may take 2 months and full function may take 6 months.
- Our goal is to ensure you are well taken care of and supported during and after surgery.
- Weekly appointments are required for up to two months after surgery.
- Long term follow up is required for at least 12 months post op.