Orthognathic surgery is needed when jaws don’t meet correctly or if the teeth don’t fit with the jaws. Teeth are straightened with orthodontics, and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.
People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Injury to the jaw, birth defects such as cleft lip or palate and altered facial growth patterns are some of the main causes of orthognathic problems. Patients with cleft lip or palate often require orthognathic surgery in their late teen years.
If you are a candidate for jaw surgery, Dr. Cherry works closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional dental-facial relationship.
If surgery is necessary, Dr. Cherry explains what the advantages and disadvantages are, what is entailed in surgery, and what you can expect during the preoperative and postoperative periods. Risks and complications are also discussed with you. Dr. Cherry keeps explanations simple and uses your X-rays and dental casts to demonstrate the problems. Solutions for the problems are discussed in general terms and the need for surgery explained. The importance of preoperative alignment of the teeth and the possibility of the bite not improving, or even getting worse, during this phase is explained to you.
Treated cases with similar problems are used to demonstrate specific treatment objectives. For most patients, the treatment time is extremely important; but it is preferable not to give a specific length of time. It is important, however, to give you a general idea of the length of treatment and a treatment profile explaining various phases of the treatment, the sequence of the stages, and the time each phase could take. Dr. Cherry alerts you to factors – such as bone density, periodontal disease, patient cooperation, age and tooth extractions – that might influence the treatment time and surgical precision.
Maxillary Osteotomy (Upper Jaw) “LeFort”
A maxillary osteotomy is performed to correct any of the following issues:
In this procedure, Dr. Cherry makes bone cuts inside the mouth above the teeth and below both eye sockets; so the entire top jaw, including the roof of the mouth and all upper teeth, can move as one unit. The teeth and jaw are moved forward until the upper and bottom teeth fit together properly.
Once the jaw is realigned, tiny screws and bone plates hold the bone in its new position. These screws are smaller than a bracket used for braces and become integrated into the bone structure over time.
A person who has an open bite (apertognathia) has difficulty chewing, due to a significant space between the upper and lower front teeth when the molars are completely touching. This gap results from excess bone growing only above the molars. What is normally a flat, even surface is angled instead; so the upper teeth do not touch when a person bites down. To remedy this condition, surgeons shave away or remove the excess bone.
Mandibular Osteotomy (Lower Jaw)
A significantly receded lower jaw (retrognathia) can be corrected by a procedure called mandibular osteotomy (bilateral sagittal split ramus osteotomy).
In this procedure, Dr. Cherry makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. As a result, the jaw slides smoothly to its new position. Screws hold the jawbone together until it heals.
Chin Surgery (Genioplasty)
A severely receded lower jaw is often accompanied by a deficient chin. This condition can be remedied with a procedure called genioplasty (mandibular anterior-inferior border osteotomy). Typically, Dr. Cherry can alter the jaw and restructure the chin during the same surgery.
The following information is provided to ensure that many of the details of postoperative care are covered prior to your surgical procedure. This will ensure a smooth and uneventful recovery. It has been our experience that the more information and preparation patients have prior to their surgery, the more easily they are able to manage their postoperative care.
Risks & Side Effects
Like any surgery, jaw surgery poses some health risks. Most of these are rare, but you should be aware that surgery can be unpredictable.