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Orthodontic Surgery
Surgical orthodontics, also known as orthognathic surgery, involves re-positioning one or both jaws to correct facial and jaw irregularities. This procedure is typically done in conjunction with orthodontic treatment to ensure the teeth are properly aligned after surgery. The goal of orthognathic surgery is to improve chewing, speaking, and breathing abilities, as well as enhance the overall appearance of the face. The term "orthognathic" refers to straightening the jaws, similar to how "orthodontics" refers to straightening teeth.
Here are some signs that may suggest the necessity of corrective jaw surgery:
- Trouble chewing or biting food
- Difficulty swallowing
- Persistent jaw or TMJ pain and headaches
- Excessive tooth wear
- Gap between upper and lower teeth when mouth is closed
- Uneven facial appearance from front or side
- Facial injury or birth defects
- Chin that appears to be receding
- Jaw that protrudes
- Difficulty making lips meet without straining
- Chronic mouth breathing and dry mouth
- Sleep apnea, including snoring, while sleeping
Orthognathic Surgery Steps:
Before undergoing surgery, orthodontic treatment will adjust the position of your teeth so that they align properly when your jaws are surgically repositioned. This pre-surgical orthodontic phase typically lasts 6-18 months and involves wearing braces and regular visits to your orthodontist for adjustments and evaluations.
It may seem like your bite is worsening during this phase as your teeth are being moved into a position that will be correct after surgery. However, during orthognathic surgery, the oral and maxillofacial surgeon will align your jaws properly, resulting in your teeth moving into the correct position. After surgery, additional orthodontic treatment may be needed to fine-tune your bite. Following the removal of your braces, you may need to wear a retainer. If you still have wisdom teeth or your teeth are overcrowded, it may be necessary to remove certain teeth before starting orthodontic treatment to create space for proper tooth movement.
The Surgery Procedure
Orthognathic surgical procedures can last anywhere from one to several hours, depending on the specific surgery needed. During lower jaw surgery, the rear portion of the jawbone behind the teeth is separated and the tooth-bearing portion is moved either forward or backward. In upper jaw surgery, the jaw can be re-positioned in various ways, such as forward or backward, or raised or lowered.
Some movements may require the jaws to be separated into multiple parts, with bone added or removed to ensure proper alignment and stability. Other facial bones that contribute to the imbalance may also be re-positioned, augmented, or reduced in size. Incisions are typically made inside the mouth to minimize visible scarring, but if an external incision is necessary, it is carefully placed to blend in with natural skin creases.
Healing in Progress
After leaving the hospital or surgical facility, you may be able to return to work or school within two weeks. Your appearance may have changed due to jaw re-positioning and swelling, so be prepared for reactions from family and friends. Your oral and maxillofacial surgeon and orthodontist will schedule regular evaluation visits, which are important for monitoring healing and removing fixation devices if necessary.
The initial healing phase will last about 6 weeks, with complete healing taking 9 to 12 months. Good oral hygiene is crucial during this time, and your healthcare providers can recommend special oral care devices. Orthodontic treatment typically begins 4 to 8 weeks after surgery to adjust your bite, with braces usually removed within 6 to 12 months.