Orthognathic Surgery Eating and biting can be difficult for people whose jaws and teeth don't meet correctly. Some people may be troubled because their faces appear "unbalanced". Orthognathic surgery is designed to correct these problems which are due to deformities caused by the way in which the teeth and jaw have grown, disease, or injury. The result can be an abnormal relationship between the upper and lower teeth. The word orthognathic comes from two Greek words - orthos, meaning straight and gnathos, meaning jaws. Orthognathic surgery is considered when a person's bite cannot be fully corrected with braces. What are some of the conditions that can be helped by orthognathic surgery? If you experience problems with biting or chewing or if your lower teeth hit the roof of your mouth when you eat, you may be a candidate for orthognathic surgery. Another indication that may cause you to consider the procedure is your dissatisfaction with your appearance. If your face seems unbalanced or if you do not like how you look, this surgery can help correct the problem. What is meant by facial imbalance? Your face gets its structure from your facial bones. If the jaw is proportional, these bones correspond to each other exactly. As a result, you are likely to have a normal bite and a pleasing relationship between your forehead, nose, lips and chin. If, however, these bones are not shaped correctly, there can be problems with your jaws, teeth or appearance which is referred to as "facial imbalance". These can occur when the lower jaw is underdeveloped resulting in a receding chin or in upper teeth overlapping the bottom teeth (Fig. A). With an overdeveloped lower jaw, the chin juts out, (Fig. B) and chewing can be difficult. An underdeveloped lower jaw usually exposes too much of the top gums, (Fig. C) and an underdeveloped upper jaw can cause the upper lip and teeth to appear receded. Jaws can be overdeveloped or underdeveloped on one side only (Fig. D) which can make chewing difficult and the face appear unbalanced. How is a person prepared for this surgery? Your orthodontist and oral surgeon work together to evaluate your problem and decide how best to treat it. The orthodontist's job is to determine how braces can prepare you for surgery which will be performed later by the surgeon. Before treatment begins, a complete history is taken and x-rays of your mouth and skull may be ordered. Casts are usually made of the teeth and photographs taken for later comparisons. Before any work is undertaken, you may be advised to visit your general dentist for a cleaning and to treat any other problem that you might have. Before surgery can take place, braces will be positioned in your mouth by your orthodontist who will watch your progress very carefully. The braces are usually worn for several months, but the time varies from individual to individual. When your orthodontist and surgeon have determined that your teeth have moved into the correct position, the surgery will be scheduled. What happens before, during and after surgery? Orthognathic surgery is usually done in a hospital setting and involves a one to two day stay. Prior to entering the hospital, your surgeon will discuss with you the procedure, how to prepare for it and what to expect afterward.
After entering the hospital, an anesthesiologist or nurse will describe what anesthesia will be used as well as the IV (intravenous) fluids and medications you will receive. These will help prevent dehydration and reduce pain and swelling. Immediately before surgery, you will be given a general anesthesia which will keep you asleep during the procedure. The procedure used to correct your jaw problem will depend on the particular condition you have. Incisions are made within the mouth so that scars will not be visible. Often the jaw is sectioned and then moved to the proper location. Bones are kept from moving with the use of special appliances which the surgeon chooses. These may be screws, plates, splints or wires. When you awake following surgery, you will probably be groggy and may experience some numbness in the treated area. Your face will appear swollen, and you might have some discomfort which pain medication will help alleviate. Most of the swelling and numbness will disappear after a few weeks, but you may experience these conditions somewhat longer. You will be given instructions on when to clean your teeth and how to care for your mouth. You may be instructed to be off work or school for two or more weeks. You will be advised to drink a lot of fluids in order to prevent dehydration, and an initial diet of soft foods will be recommended. Facial exercises to help improve the flexibility of your jaw may be suggested. Changes in your appearance may not be immediately noticeable because of swelling around the area. As the swelling goes down, very slight to very dramatic changes may be apparent depending on the procedure. What kind of follow-up care will I receive? You may be wearing braces for a year or more after surgery which will require you to visit your orthodontist regularly. The orthodontist will make certain that your teeth are moving into the correct position by adjusting the braces. When the teeth are positioned correctly, the braces will be removed; however another appliance, a retainer or positioner may be recommended. Your surgeon will see you soon after surgery and will remove those appliances such as wires that need to come out. What are the risks and complications connected with orthognathic surgery? Orthognathic surgery is performed very often with excellent results; however, all surgeries involve certain risks which your surgeon will discuss with you. Complications occur infrequently but can include a feeling of numbness or stiffness of the face for a period of several months. Other complications that can occur include infection or a shifting of the bones. These are not common occurrences; however, your surgeon will discuss them with you prior to surgery. What does this type of treatment and surgery cost? Costs will vary depending on how involved the procedure is. Many insurance plans cover some or all of the costs; however, people who are considering this surgery should check with their insurance agents. If you are interested in learning more about orthognathic surgery, please call our office and we will be happy to answer your questions. Copyright © 2000 Contemporary Health Communications, Earth City, Missouri (Commercial use strictly prohibited) |
