Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patientís ability to chew, speak, and breathe. It also provides improved facial balance and aesthetics. Moving the jaws also moves the teeth, so braces are always used in conjunction with jaw surgery. This ensures that teeth are in their proper positions after surgery.
Who needs surgical orthodontics?
Your orthodontist carefully evaluates diagnostic information such as panoramic and cephalometric X-rays, intra- and extra-oral photographs, and study models of the teeth to determine the amount of skeletal imbalance. If the imbalance is severe, often times, orthognathic surgery is required for complete correction.
If your orthodontist diagnoses a severe skeletal discrepancy in a growing child, orthodontic treatment will usually be initiated while the child is still growing in an attempt to guide the growth of the jaws into a more favorable relationship, thereby reducing the severity. Sometimes, in situations of severe discrepancies, orthognathic surgery may still be required for complete correction of the skeletal imbalance once growth is complete. Jaw growth is usually complete no sooner than 16 years of age in females and 18 years of age in males. Since there is great individual variation, an X-ray of the hand and wrist is often taken to determine the amount of skeletal growth remaining. Jaw surgery can not be performed until most, if not all, skeletal growth is complete. However, orthodontic appliances are usually placed 6-12 months prior to surgery to allow time to straighten the teeth.
Adults with severe discrepancies in jaw position often require orthognathic surgery for complete correction since there is no growth remaining. In many instances, orthodontic treatment as a child can modify growth and reduce or eliminate the need for jaw surgery as an adult.
How does it work?
During your orthodontic treatment, usually lasting 6-12 months before surgery, you wear braces and will visit your orthodontist for scheduled adjustments. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper alignment as well.
Surgery is performed in the hospital with an oral surgeon, and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.
When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4-8 weeks), your orthodontist "fine-tunes" your bite. In most cases, braces are removed within 6 to 12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.