Orthognathic surgery
Orthognathic surgery is a surgery performed on the bones of the jaw and face to change their position. This surgery is a corrective facial surgery where deformities of the jaw exists .The surgery is done commonly in conjunction with orthodontic (braces) treatment which straightens the teeth for a better functional , cosmetic or health reasons.
Who needs Orthognathic treatment??
People with large jaws or chins that are forwardly placed , or small jaws or chins that are backwardly placed , teeth which do not fit together , eye balls which appear bulging ,cheekbones that are flat , crooked or jaws that are deviated /shifted to one side or other ( asymmetry) , cleft lip and palate patients , or disfigurements after accidents /trauma or other birth defects are some characteristics that may suggest a need for surgical corrections along with braces or orthodontics .
Planning before surgery
The decision to whether the deformity can be corrected only by braces or by combined surgery and braces /orthodontics are determined by the specialised dentists called Oral & Maxillofacial surgeon and the Orthodontists by studying the face and jaws with dental casts , plaster models , candidate photographs , CT scans and analysing specific points and calculations on a facial X RAY (cephalogram) and other tools to accurately determine where exactly the problems lies and what exactly should be done to set right the deformity .
What the surgeon and orthodontist treating actually do??
The orthodontist first aligns and straighten the teeth before surgery with braces to a position he expects the normal jaws to have . Following which the date of surgery is decided and splints /plastic guiding trays are designed to accurately place the jaws in position during surgery.
Though some minor surgeries can be performed under local anaesthesia in a dental office itself , it is most preferably be done in a hospital under general anaesthesia as the surgery typically lasts three or more hours.
During the time the Oral and Maxillofacial surgeon makes cuts inside the mouth in oral mucous membrane, therefore the face is not disfigured by scars.
The lower and or the upper jaw is/are split along into three parts: two joint bearing side parts and a central part which contains teeth. Then the central part is moved to the needed position: advanced or set back, rotated if needed and fixed to the side parts with titanium plates and screws. Surgery ends when all incisions are closed in the mouth and patient is ready for recovery.
Patient may have to stay in hospital for 2 to 3 days after surgery to have antibiotics, pain killers and for rest.
Immediate post operative care
After the surgery, patients are often required to adhere to an all-liquid diet. After time, soft food can be introduced, and then hard food. Diet is very important after the surgery, to accelerate the healing process.
Swelling is common and brief period of facial discoloration due to minor blood clots and numbness of facial region are possible . A period of continued use of braces after surgery may be needed to do final corrections to teeth to ensure stability.
What is the final result following the procedure??
After the surgery and recovery the patient achieves normal bite helping in eating food and function more normally, more normal facial features / better looks that immensely improve confidence, help close the lips together which was not possible earlier and help speak clearly .
Health of the teeth, gums and particularly jaw joints (Temporomandibular joint) may be in jeopardy if surgery is not done.
Sleep apnoea and snoring can be greatly corrected by forwardly placing the jaws surgically.
Deformities due to lack of growth following injury or deformities like clefting of lips / palate can be set right even in adults.
One cannot ignore the fact that one’s facial appearance can influence one’s quality of life in many ways.
Dr lakshith biddappa M.A
Oral and maxillofacial surgeon , Dental Surgeon
Complete Dentistry – Dental clinic and implant center
Mysore
Email : bidz85maxfax@gmail.com