ORTHODONTICS

Orthognathic surgery

What is orthognathic surgery?

It is a technique used to correct changes in the growth of the jaws, known as dentofacial anomalies, which can lead to bite, joint and breathing disorders, and also affect facial aesthetics.

It is, therefore, an aesthetic-functional procedure capable of restoring facial harmony and masticatory function.

Who performs orthognathic surgery?

The surgery is performed by a maxillofacial surgeon in a hospital setting under general anesthesia.

Indication

This technique is indicated for several types of bone anomalies, from deficient to exaggerated growths, in all directions. So that it can be performed, after the diagnosis of the patient's condition, several assessments are made to plan the best form of treatment.

In children, one usually tries to correct the problem with the use of orthodontic and orthopedic appliances that also act on bone growth. However, when the patient with the anomaly is an adult, isolated orthodontic treatment will not be sufficient for the correction, because the process of facial growth has already occurred and therefore will be over. In these cases, orthognathic surgery will be necessary for the complete correction of the problem. .

Preparation

In preparation for surgery, the patient must undergo orthodontic treatment, in which the position of the teeth is corrected according to the bone bases: the upper teeth in relation to the maxilla and the lower teeth to the mandible. At this stage, a better fit between the upper and lower teeth should not be sought, that is, the correction of dental occlusion. The orthodontist's job is to prepare the dental arches so that the surgeon can correct the occlusion at the time of surgery, by moving the bone bases.

Once the orthodontic preparation is completed, the surgery is simulated, currently using virtual 3D methods on the computer. With it, surgeon and patient can evaluate all the possibilities and visualize the aesthetic results very accurately.

Upon approval of the planning, the patient returns to the orthodontist for the installation of the hooks in the orthodontic wire to assist in the fixation of the structures during the surgery.

The surgical procedure

In most cases, orthognathic surgery is performed from the inside of the mouth. It is rarely performed with a cut on the face. The procedure basically consists of “releasing” the maxilla (the upper jaw), the mandible (the lower one) or the chin and sometimes all of them. The fixation of the structures in the new position is performed with mini plates and mini screws, usually titanium.

Postoperative

After the surgical procedure, the patient may encounter some difficulties. Diet, hygiene and speech can be momentarily impaired by the marked swelling of soft tissue. Only liquid foods are allowed and a balanced diet is advised. It tends to be more difficult in the first and second weeks. Usually within 30 days the patient is able to start the gradual return to routine activities.

Finalization

The final result is obtained after six months, and it is always important the dentist's monitoring in all phases of the postoperative period. During this period, orthodontic finishing, fine adjustment of the bite, which usually lasts from 3 to 6 months, is performed. Only after this phase will it be possible to remove the orthodontic appliance and start the retainer phase.

Source FOUSP