Orthognathic surgery is a common treatment that addresses orthodontic problems that have an underlying problem relating to the jaw pattern. Many orthodontic problems encountered, although appearing as a poor dental pattern, are related to the size and/or position of the jaws.
Orthognathic surgery concerns the movement of the upper (maxilla) and/or lower (mandible) jaw to match the teeth into the correct bite (occlusion) and in many situations facial balance is also improved. The surgery is performed by Oral and Maxillofacial Surgeons who are specialists in surgery related to the mouth, jaws and associated facial structures. The surgery is performed under general anaesthesia in a modern hospital setting.
Coordinated orthodontic and surgical treatment results not only in an improved relationship between upper and lower teeth, but usually includes a beneficial change in facial profile and lip posture. The aim of the surgery is simply to give the jaws the shape and form they would have had if growth had been harmonious. We are not necessarily aiming to make wholesale cosmetic changes.
Combined orthodontic-surgical treatment generally takes about 24 months and usually proceeds as follows:
1. Treatment planning: as with all our patients, you have had a full orthodontic work-up using study moulds of the teeth, x-rays and photographs. The surgeon will also complete a work-up and then discuss the options with you. We would like you to feel completely comfortable with your chosen option prior to commencing treatment.
2. Orthodontics prior to surgery: orthodontic treatment for about 12 to 18 months before the surgery. Any lower wisdom teeth should be removed.
3. The surgery: The surgery is performed from inside the mouth. Miniature bone plates and screws are utilised to hold the jaw in its new position. Your jaws will not be locked together after surgery. Complete bony healing occurs after 2 to 3 months but adequate strength for chewing and recommencing orthodontic treatment is present after 4 to 5 weeks. The surgery is performed approximately 12 months following commencement of the orthodontics.
4. Orthodontics following the surgery: this involves detailing of the teeth to allow for the best interlocking of the teeth. This phase usually takes 6 to 12 months.
5. Retention and supervision: following treatment with braces retainer appliances are worn for at least 2 years to hold the teeth in their new positions.