Orthognathic surgery, also known as corrective jaw surgery, is a surgical procedure performed to correct abnormalities of the jaw and facial skeleton that affect bite alignment, facial aesthetics, and function. It involves repositioning the upper jaw (maxilla), lower jaw (mandible), or both to achieve better harmony and balance between the jaws, teeth, and facial structures.
Orthognathic surgery may be recommended for individuals with the following conditions:
- Malocclusion: Severe misalignment of the teeth and jaws, such as underbite (prognathism), overbite (retrognathism), crossbite, open bite, or asymmetry.
- Facial Skeletal Deformities: Congenital or acquired abnormalities of the facial bones, such as a disproportionately small or large jaw, facial asymmetry, or cleft lip and palate.
- Obstructive Sleep Apnea (OSA): Orthognathic surgery may be considered as part of the treatment for obstructive sleep apnea when the condition is caused by structural abnormalities in the upper airway, such as a retruded or narrow jaw.
- Temporomandibular Joint (TMJ) Disorders: Severe TMJ disorders that cannot be adequately managed with conservative treatments such as medication, physical therapy, or splints.
The orthognathic surgery process typically involves the following steps:
- Comprehensive Evaluation: Before recommending orthognathic surgery, a thorough evaluation is conducted by an interdisciplinary team, including oral and maxillofacial surgeons, orthodontists, and sometimes other specialists such as speech therapists or sleep medicine physicians. This evaluation may include dental and facial measurements, imaging studies (X-rays, CT scans, or MRI scans), and dental impressions.
- Orthodontic Preparation: Orthodontic treatment is often an essential component of orthognathic surgery and may be initiated several months before surgery to align the teeth and create space for jaw movement. Braces or other orthodontic appliances are used to gradually move the teeth into their ideal positions in preparation for surgery.
- Surgical Planning: Using the information obtained from the evaluation and orthodontic treatment, a surgical plan is developed to address the specific jaw abnormalities and achieve the desired outcomes. This may involve computerized simulation and 3D modeling to visualize the planned surgical changes.
- Surgery: Orthognathic surgery is performed under general anesthesia in a hospital setting. The surgeon makes incisions inside the mouth (intraoral) or in the facial skin (extraoral) to access the jaw bones. The bones are then carefully cut, repositioned, and stabilized using specialized techniques such as bone plates, screws, or wires. In some cases, additional procedures such as genioplasty (chin surgery) or rhinoplasty (nose surgery) may be performed concurrently to enhance facial harmony.
- Recovery: Following surgery, patients typically stay in the hospital for a few days for monitoring and pain management. Swelling, bruising, and discomfort are common in the days and weeks following surgery, but these symptoms gradually subside with time. A soft or liquid diet may be recommended initially, followed by a gradual transition to solid foods as healing progresses. Patients are typically advised to avoid strenuous activities and follow postoperative instructions provided by their surgical team.
- Orthodontic Follow-Up: After the initial healing period, patients continue orthodontic treatment to fine-tune the bite and tooth alignment. This may involve wearing retainers or other orthodontic appliances to maintain the results achieved through surgery.
Orthognathic surgery can have significant benefits in terms of improving bite function, facial aesthetics, and overall quality of life for individuals with jaw abnormalities. However, it is a complex procedure that requires careful planning, coordination between multiple healthcare providers, and commitment from the patient throughout the treatment process. If you are considering orthognathic surgery, it’s essential to consult with an experienced oral and maxillofacial surgeon who can evaluate your specific needs and develop a personalized treatment plan.
