|Orthognathic surgery is the surgical correction of skeletal deformities of the oral and maxillofacial region and may be necessary for patients with an improper bite or whose jaws are positioned incorrectly. Orthognathic surgery involves 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. Such corrections are largely achieved by osteotomies, surgical techniques by which parts of the jaw are cut to create separate fragments which can then be moved into new positions with preservation of their blood supply. The surgery is performed by Oral and Maxillofacial Surgeons who are specialists in surgery related to the mouth, jaws and associated facial structures. Surgery is performed under general anesthesia in a hospital setting.
Since jaw growth is a gradual process, sometimes the upper and lower jaws may grow at different rates, leading to problems that can affect speech, appearance, chewing and long-term oral health. A birth defect, an injury to facial bones and jaws, and pathologic influences or heredity can also affect jaw alignment. The jaw joint (TMJ) may also be adversely affected. In addition, jaws of different sizes can affect your appearance. The most common indications for such procedures are the correction of facial deformity, dental appearance, eating and biting problems caused by malocclusion and speech abnormalities. When there is facial asymmetry, perhaps because one side of the face has failed to develop properly or alternatively has grown too much, orthognathic surgery may be used to correct the problem. Orthognathic surgery also has an important role to play in the management of congenital craniofacial syndromes, for example clefts of the lip and palate and other deformities of development of the face and skull. In the more severe cases obstructive sleep apnea (OSA), surgery is needed to reposition the jaws forward to increase the size of the airway
In most cases, this is elective surgery and the informed wishes of the patient are paramount in deciding whether to carry out treatment. Except in the most severe deformities, or when there are major psychological or social problems, surgery is usually delayed until jaw growth is complete. In the management of these cases, the oral & maxillofacial surgeon works very closely with an orthodontist. The vast majority of orthognathic cases require a period of orthodontic treatment with fixed appliances in preparation for surgery. This enables optimum correction of the dental occlusion as well as the appearance of the face and teeth. Although sometimes it is necessary to hold the upper and lower teeth together after surgery to allow the osteotomies to heal, modern techniques of internal fixation using small plates and screws avoid this necessity in the overwhelming majority of cases. Following surgery, the orthodontist needs to complete the tooth positioning and this may take from as little as 3 months up to 12 months in difficult cases. Coordinated orthodontic and surgical treatment goals are to improve relationship between upper and lower teeth, to improve function and restore facial balance by placing the teeth and jaws into a more favorable position.
Although the goal of this surgery is to improve your bite and function, most patients also experience enhancements to their appearance and speech. The results of corrective jaw surgery can have a dramatic and positive effect on many aspects of your life.