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Orthognathic surgery is a surgical correction of the skeletal anomalies or malformations involving the mandible (lower jaw) or the maxilla (upper jaw). These malformations may be present at birth or they become evident as the patient grows and develops. These jaw malformations will manifest themselves by your teeth not properly occluding against each other.
Surgical Orthodontic treatment is comprised of two phases:
1- Your orthodontist in consultation with your surgeon will apply braces and straighten your teeth. During this phase your occlusion may actually worsen as your teeth are being positioned to perfectly fit against the opposite dentition following surgery.
2- Once your teeth have straightened then corrective jaw surgery repositions misaligned jaws and assures correct occlusion of teeth. This procedure not only improves facial appearance, but also ensures that teeth meet correctly and function properly.
Who Needs Orthognathic Surgery?
People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. However, teeth can only be moved a certain amount. Orthognathic surgery may be required for correction of larger discrepancies. If you are a candidate for Corrective Jaw Surgery, our surgeons will work closely with your physician, dentist and orthodontist during your treatment. The actual surgery will move your teeth and jaws into a new position that results in a more attractive, functional and healthy dental-facial relationship.
Difficulty in the following areas should be evaluated:
- Difficulty in chewing, biting or swallowing
- Speech problems
- Chronic jaw or TMJ pain
- Open bite
- Protruding jaw
- Breathing problems
Any of these symptoms can exist at birth, be acquired after birth as a result of hereditary or environmental influences or as a result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with radiographs. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team will make the decision to proceed with treatment together.
An oral and maxillofacial specialist is thoroughly qualified to repair facial injuries. These professionals are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation – not just for physical reasons, but for emotional ones as well. Injuries to the face, by their very nature, impart a high degree of emotional as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long-term function and appearance.
Our surgeons meet and exceed these modern standards. They are trained, skilled, and uniquely qualified to manage and treat facial trauma. They are on staff at local hospitals and deliver emergency room coverage for facial injuries, which include the following conditions:
- Facial lacerations
- Intraoral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, nose, or eye socket)
- Fractured jaws (upper and lower jaw)
The Nature of Maxillofacial Trauma
There are a number of possible causes of facial trauma, such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries to teeth to extremely severe injuries to the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves, or the salivary glands).
Soft Tissue Injuries of the Maxillofacial Region
When soft tissue injuries, such as lacerations, occur on the face they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Our surgeons are well-trained oral and maxillofacial surgeons and are proficient at diagnosing and treating all types of facial lacerations.
Bone Injuries of the Maxillofacial Region
Fractures to the bones in the face are treated in a similar manner to fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, and the age and general health of the patient. When an arm or leg is fractured a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and eliminates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of rigid fixation has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.
Injuries to the Teeth & Surrounding Dental Structures
Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone, or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon, such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists, who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.
The proper treatment of facial injuries is now the realm of specialists who are well versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.