What is orthognathic surgery?

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Cosmetic and Restorative Care
BSc, BDSc (Melb)

What is orthognathic surgeryOrthognathic surgery, also known as corrective jaw surgery, is the repositioning of one or both jaws.

Orthodontics is the treatment used to correct the alignment of the teeth. When combining orthognathic and orthodontic treatment you are improving the relationship between the upper lower teeth.

Orthognathic surgery is usually recommended when there has been a significant jaw growth imbalance resulting in a considerable malocclusion or “bad bite”.

In these situations, simple alignment of dental arches with orthodontic appliances alone cannot produce a satisfactory aesthetic or functional outcome.

This is primarily because the orthodontic appliances such as braces or Invisalign treatment will only move the teeth and have very little effect on irregular jaw positions.

The benefits of the combined treatment may include improved jaw function, facial appearance, the ability to chew and bite, and in certain cases speech.

Who performs the treatment?

Orthognathic surgery is performed by a registered specialist Oral and Maxillofacial Surgeon who has completed additional training in all areas of surgery relating to the facial bones, jaws, mouth and associated structure.

You will see a registered specialist orthodontist for the orthodontic component as they have also had additional training in their chosen field.

Who is suitable for orthognatic treatment?

Orthognathic surgery is generally performed on healthy adolescents and young adults who have completed growth of their craniofacial skeleton.

Sequence of treatment

Treatment takes approximately 18 to 24 months to complete. In a standard case the sequence of combined orthognathic and orthodontic treatment is as follows:

Treatment planning

Initially you will require separate consultations with the specialist orthodontist and Oral and Maxillofacial Surgeon for an analysis and discussion.

Models, photographs and x-rays will be taken to assist in the treatment planning phase.

You will receive a written treatment plan with a quote and associated item numbers which can be used to check your rebate through your private health insurance if applicable.

Orthodontics prior to surgery

Your teeth must be adequately aligned prior to commencing jaw surgery.

Braces will be worn approximately 8 to 16 months prior, this assists the Oral and Maxillofacial Surgeon with achieving the ideal jaw position.

Once the pre-surgical phase of your orthodontic treatment is nearing completion you will consult with your surgeon again and a new set of records will be taken to plan and schedule your surgery.

Surgical treatment 

Corrective jaw surgery is performed at a private hospital under general anaesthetic.  On the day of surgery you will meet with your anaesthetist who will discuss the anaesthetic component of the procedure with you.

Expect to stay in hospital for between one to three days and arrange 1-2 weeks off work/school in the first instance. Initially you will have some swelling and bruising, with limitation in jaw movement. Your new jaw position is held in place by small titanium plates and screws that are placed during surgery.

In addition, you will have elastic bands placed from the upper braces to the lower braces in order to support the new jaw position in the early phase whilst the jaw(s) are healing. You will be given an exercise and dietary plan to follow which will assist in the recovery phase of surgery. Expect your jaw to be stiff initially after elastics are removed.

Regular review appointments will be made to check the healing and jaw position, new x-rays will be taken to monitor treatment progress.

Orthodontics post surgery

Orthodontic treatment after surgery takes approximately 6 to 8 months to complete.

Preparation for the operation

Tests

Prior to your admission the surgeon may require you to have some blood tests depending on the type of surgery proposed.

Smoking

If you are a smoker, the anaesthetist strongly recommends that you stop at least two weeks prior to any operation. Smoking is also associated with higher postoperative infection rates and impaired or delayed wound healing.

Mouth Care

It is important that your mouth is as clean as possible before your surgery.  Please clean your teeth thoroughly twice a day and floss daily.

Medication

Avoid taking any aspirin/dispirin, medication containing aspirin, Naprogesic and Ponstan during the month prior to and the months following your surgery

Fasting Instructions

  • Morning surgery: Do not eat or drink after midnight
  • Afternoon surgery: Do not eat or drink after 7:00 am

After surgery

You will be given a care pack after your surgery which will include pain relief, mouth rinse, your review appointment time and a post operative instruction pamphlet which will include all dietary and care advice.

Avoid during recovery

  • Blowing your nose or excessive sniffing
  • Smoking, as your ability to cough effectively can be reduced due to the swelling.  This can lead to a chest infection
  • Alcohol
  • Excessive physical exertion for the first 14 days.

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