ORTHOGNATHIC SURGERY

Treatment identity

Basic information

Procedure duration: 2 -4 hours

Anesthesia: General

Hospitalization: 1-2 days

Postoperative period: The patient develops edema, which peaks in the first 48-72 hours and remains for 7-10 days. The pain lasts 3-4 days, but it is perfectly manageable with painkillers.

Return to activities: 10 – 15 days after the procedure.

Effects: After the edema subsides; they are gradually improved.

Duration of effects: Permanent.

What is orthognathic surgery

The importance of jaws in facial symmetry

Jaw misalignment and/or asymmetrical development are the causes for a series of functional and aesthetic problems on the face.

Prognathism or retrognathism, malocclusion and, due to them, chewing, speech, swallowing and breathing disorders. Some of these problems can be corrected, to a certain extent, with orthodontic treatment (jaw misalignment due to crooked teeth is mainly corrected this way).

However, the correct approach is to initially reach out to a maxillofacial surgeon. Following a series of specialized examinations and measurements, he will prepare a comprehensive treatment plan. If the cause of the problems is some abnormality in the development of jaws and facial bones, the restoration will be performed with the proper orthognathic surgery, namely a procedure that will correct the dysplasia of the jaws and the facial bones and improve the functionality of the stomatognathic system and the aesthetic look of the face.

ORTHOGNATHIC SURGERY

What orthognathic surgery achieves

The main aims of Orthognathic Surgery are the correction of facial asymmetry and the restoration of breathing and chewing functionality, malfunctions mainly due to the proportions between the two jaws. The upper or the lower jaw can be deficient (micrognathia) or excessive (macrognathia).

In more detail, the following can be achieved with orthognathic surgery:

·       Restoration of symmetry and harmonious proportions – correction of prognathism
        or retrognathism
·       Improvement of the ability of the lips to close properly
·       Reduction of the symptoms of obstructive sleep apnoea
·       Corrections of dental occlusion disorders
·       Improvement of chewing
·       Protection of teeth from excessive wear
·       Improvement of speech
·       Improvement of – relief from the pain caused by the functional
disorder of the temporomandibular joint
·       Restoration of facial deformity or congenital anomailes (cleft of lip and palate)
·       Treatment of hypertrophic or hypoplastic chin (genioplasty)
·       Restoration of facial deficits caused by neoplasms or injuries.

ORTHOGNATHIC SURGERY

Types of Orthognathic Surgery Procedures

Orthognathic Surgery procedures aim to move jaws to the correct position. That is achieved with osteotomy, namely the creation of a “fracture” at the jaws, to enable their free movement in 3 dimensions.

Three types of surgical procedures are usually applied in Maxillofacial surgery, either separately or in combination, to offer the desired functional and aesthetic effects. These are the following:

·       Le Fort 1 Osteotomy to move the upper jaw (maxilla)

·       Sagittal Osteotomy of the Lower Jaw (mandible) that is applied, with appropriate modifications, in a number of skeletal abnormalities of the lower jaw (prognathism, retrognathism or asymmetry of the lower jaw, treatment of sleep apnoea).

·       Genioplasty, which is applied individually for aesthetic reasons in cases of progenism, retrogenism or asymmetry of the mentum (chin), and in combination with the sagittal osteotomy of the lower jaw, when major movement of the jaw is required.

EFFECTS

Before & After

ORTHOGNATHIC SURGERY

All you want to know

How Orthognathic Surgery procedures are performed

Orthgnathic Surgery procedures are performed on patients that have completed the 17th – 18th year of age, for jaw development to be completed. The procedures are mostly performed under general anesthesia and last 2-4 hours. After the procedure, hospitalization of 1-2 days is required.

State-of-the-art techniques and materials enable the oral-maxillofacial surgeon to accurately perform atraumatic osteotomies, to protect nerves and vessels from injuries and to ensure fixed jaw position in the surgery, so that intermaxillary fixation is not needed after the surgery. That is very important, as it means the patient won’t need to have wires on his/her teeth for the next two months, which was a requirement in previous years.

As all incisions are made inside the mouth, no scar or mark is left on the face.

Recovery – The first days after the orthognathic surgery

The pain due to orthognathic surgery in the first 4-5 days is effectively managed with painkillers, and the patients also receive antibiotics. To facilitate nasal respiration, decongestant drops are recommended, while for the first month patients are asked to brush their teeth three times a day with a soft toothbrush.

Caution is also needed with the patient’s diet after a maxillofacial surgery, as for a period, determined by your surgeon, you will be required to consume soft foods and liquids.

Patients return to their activities in 10 – 15 days after the surgery. In less than two months the patient feels well, but full healing of the jaws lasts from nine months to one year.

ORTHOGNATHIC SURGERY

Combination of Orthognathic Surgery with Orthodontic Treatment

Most of the time orthodontic treatment both precedes and follows the surgery.

In the majority of cases, orthognathic surgery is combined with orthodontic treatment.

The maxillofacial surgeon following the clinical examination, the results of imaging screening (it includes panoramic x-ray, lateral cephalometric radiograph, three-dimensional computed tomography) and the teeth molds, will determine the treatment plan. That does not include only the orthognathic surgery, but also the orthodontic treatment, which, most of the time both precedes and follows the surgery.

Before the surgery, orthodontic treatment is needed to move the teeth to the positions that, after the orthognathic surgery, will allow the perfect dental occlusion, to maintain the consistency of the effects.

After the surgical procedure, orthodontic treatment continues for some more months, to refine dental occlusion.