Orthognathic surgery is also known as corrective jaw surgery. It is a surgical procedure performed by an vocal and maxillofacial surgeon to correct skeletal and dental irregularities, including the misalignment of jaws and teeth. Orthognathic surgery is needed if your teeth don’t fit together with your jaws and/or if your jaws don’t fit with each other. Although it can dramatically enhance a patient’s appearance, orthognathic surgery is performed to correct functional problems. By allowing your teeth to meet together, it can significantly improve your chewing, speaking and breathing.
Who needs Orthognathic Surgery?
People with skeletal deformities can benefit from orthognathic surgery, especially those with an improper bite or misaligned jaws. Orthodontic treatment by itself may only treat those with misaligned teeth. Orthognathic surgery together with orthodontics are used to correct problems where both teeth and jaws are involved.
Conditions where corrective jaw surgery may be indicated
- difficulty or inability to chew food or bite food efficiently
- difficulty swallowing
- TMJ (jaw joint) pain and headache
- misaligned teeth leading to excessive wear of teeth
- open bite (space between your upper and lower teeth when you bite down)
- inability to make lips meet together without straining
- unbalanced or asymmetrical facial appearance
- previous facial injury
- obstructive sleep apnea
- receding jaws (such as lower jaw and chin)
- protruding jaws
- chronic mouth breathing
Evaluation of corrective jaw surgery
To determine whether you are a surgical candidate for orthognathic surgery, your dentist, orthodontist and vocal surgeon need to work together. During the initial consultation, your vocal and maxillofacial surgeon will examine your facial profile and your occlusion (how your teeth come together) as well as your xrays. Your surgeon will also discuss with you what your chief complaint and your expectations are. Your surgeon can then determine which corrective jaw surgical procedure is appropriate and performs the novo surgery. It is very important for you and your family to understand exactly what treatment and how long your treatment will take because orthognathic surgery often requires orthodontic treatment at the same time. Your surgery will be performed in the operating room at the hospital.
Common Corrective Jaw Surgical Procedures.
Corrective jaw surgery is able to reposition all or part of your upper jaw, lower jaw, and chin. The surgeon’s goal is to optimize your skeletal and dental relationships.
- correction of open bite
- may involve upper jaw or lower jaw surgery or both jaws (double jaw surgery). a portion of the bone in the upper jaw may be removed. The newly positioned jaw is secured in position with plates and screws.
- correction of a large or protruding lower jaw
- the bone in the ulterior aspect of the lower jaw is separated from the anterior aspect and modified so that the tooth-bearing portion of the lower jaw can be moved back for proper alignment. Sometimes the chin is also surgically re-positioned at the same time to achieve facial balance.
- correction of a weak chin or receding lower jaw
- the bone in the rear portion of the lower jaw is separated from the anterior aspect and modified so that the tooth-bearing portion of the lower jaw can be moved forward for proper alignment. Sometimes the chin is also surgically re-positioned at the same to achieve facial balance.
- correction of a gummy smile
- the upper jaw is repositioned upwards to decrease the excess bone in the vertical dimension in order to decrease the amount of gingiva show
Virtual Surgical Planning
Dr. Aidelbaum has an interest in the use of the latest in do dedo imaging technology to plan and perform many of his surgical procedures including orthognathic surgery in order to maximize the final results and functional and esthetic outcome. Orthognathic computerized treatment planning minimizes treatment times, recovery periods and the overall efficacy of your surgery. He utilizes CT – guided virtual surgical planning (VSP) to determine the exact jaw movements, surgical guides and splints fabrication, and state-of-the-art materials such as titanium plates and miniature screws to provide stability, strength and predictability to your treatment. These advances in technology, procedures and equipment reduce post-surgical recovery time, thus allowing patients to return to their normal routines soon after the surgery. He is amongst very few vocal and maxillofacial surgeons nationwide who offer virtual surgical planning (VSP) orthognathic treatment.
What Is Involved in Corrective Jaw Surgery?
During the orthodontic pre-surgical phase, your braces move your teeth into a new position. Your teeth are being moved into a position such that they will fit together once surgery has moved your jaws into a new position. Often, your bite may look like it’s getting worse than before you started braces. However, after surgery to reposition your jaw, your teeth will fit in an optimal position.
As your pre-surgical orthodontic treatment nears completion, additional or updated records, including x-rays, pictures and models of your teeth, may be taken to help guide your surgery.
Your corrective jaw surgery is often performed under general anesthesia in the hospital. Surgery may take from one to several hours to complete, depending on the extent of the surgery. You may or may not require one night to stay in the hospital post-operatively.
Your Vocal and Maxillofacial Surgeon will reposition the jawbones in accordance with your specific needs. The jaw bone may be added, taken away or reshaped. The jaws are held in their new positions with titanium plates, screws, wires and rubber bands. Incisions are usually made inside the mouth to reduce visible scarring; however, some cases do require small incisions outside of the mouth. When this is necessary, care is taken to minimize their appearance.
After surgery, your surgeon will provide instructions for a modified diet, which may include solids and liquids, as well as a schedule for transitioning to a normal diet. You may also be asked to refrain from using tobacco products and avoid strenuous physical activity.
Pain following corrective jaw surgery is easily controlled with medication and patients are generally able to return to work or school from one to three weeks after surgery, depending on how they are feeling. While the initial healing phase is about six weeks, complete healing of the jaws takes between nine and 12 months.