CORRECTIVE JAW SURGERY (ORTHOGNATHIC SURGERY)
The literal meaning of orthognathic surgery is surgery to create straight jaws, ortho meaning straight and gnathicgnathic meaning jaws. These corrections are achieved by osteotomies, surgical techniques whereby parts of the jaw are cut to create separate fragments which can then be moved and fixed with screws and plates in new positions with preservation of their blood supply.
It is not always possible to correct facial deformity and dental malocclusions (teeth biting together in an abnormal position) with orthodontics alone. When this is the case the orthodontist will refer a patient for Orthognathic Surgery. The most commonly seen conditions, which can be corrected by orthognathic surgery, are the over prominence or lack of development of either the upper or lower jaw, or both jaws. Orthognathic Surgery may also be used to correct discrepancies when there is too much or too little show of the upper front teeth or when there is an open bite deformity (when the teeth at the front of the mouth can’t be closed together).When there is facial asymmetry, 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.
The informed wishes of the patient are paramount in deciding whether to carry out treatment. To this end the treatment for the patient who is not concerned about him- or herself, or who is unsure about whether they want to have any treatment is ….. NO TREATMENT
Except in the most severe deformities, or when there are major psychological or social problems, surgery is carried out around 16 years of age when jaw growth is complete.
In Orthognathic surgery cases, the oral & maxillofacial surgeon works as part of a team. The Team Approach is the ONLY way to plan the orthognathic management of skeletal discrepancy. The team includes a maxillofacial surgeon, an orthodontist, a maxillofacial technician, dentist, dietician, hygienist and anaesthetist.
Pre operative planning is paramount. The vast amount of orthognathic cases require a period of orthodontic treatment with fixed appliances in preparation for surgery. This enables optimum correction of the dental occlusion.
Surgery may be carried out on the lower jaw, upper jaw, chin or on a combination of any of the three.
Osteotomy surgery types include:
Mandibular (lower jaw) osteotomy
Maxillary (upper jaw) osteotomy
Further information on jaw surgery can be found at http://www.aaoms.org/jaw_surgery.php