Orthognathic surgery

The orthognathic surgery is the treatment for patients who have teeth and skeletal deformities involving the face. When you can not solve the case only with orthodontic treatment, since the problem is in excess or lack of growth of the facial skeleton and not only in position of teeth, then it is necessary orthognathic surgery.


What is the origin of deformities?

These deformities may arise due to Specific Syndromes and Abnormalities (teratogenic factors, embryological factors, hemifacial microsomia, Treacher Collins, facial clefts, cranial synostosis, Pierre Robin ...), disturbances of growth after birth, facial trauma, muscle problems and hormonal or genetic in origin when there is a relative with the same characteristics.


What changes may imply the need for orthognathic surgery?

- Difficulty in chewing;
- Difficulty in swallowing;
- Excessive wear of the teeth;
- Open bite;
- Deep bite;
- Crossbite;
- Facial disharmony;
- Birth defects or sequelae of trauma in the face;
- Small or retracted chin;
- Large or Protuded chin;
- Chin diverted to one side;
- Jaw too far forward or projected;
- Jaw too far back or retruded;
- Inability to close lips without muscular effort;
- Mouth breathing;
- TMJ pain and chronic headaches,
- Syndrome of obstructive sleep apnea;


What are benefits of orthodontic and surgical treatment?

Improvement of the relationship between the teeth, muscles and skeleton
Improvement of breathing
Improvement of the positioning of the neck muscles
Improvement of the positioning of the tongue
Improvement of phonation and articulation of words
Improvement of occlusion and temporomandibular joint
Improvement of chewing and digestion
Improvement in social relationship


What are the phases of treatment?

-Insertion of fixed appliances - orthodontic treatment can take 18-24 months before the surgery to leave the teeth in a proper position
-Orthognathic Surgery-(still with braces)
-Return to orthodontic treatment after surgery to permanently improve the position of teeth
Treatment time depends on the degree of difficulty of orthodontic treatment.


How is the surgery done?

Before the surgery the doctor prepares the surgery with all necessary examinations. The diagnosis and planning of surgery are performed thoroughly before surgery with study models mounted in articulator and cephalometric radiographs. The planning takes much longer than the surgery itself.

The surgery is performed under general anesthetic. The patient is hospitalized on the morning of surgery in "absolute fasting" (can not eat any food nor drink water in 10hrs before surgery) and depending on the situation patients are discharged the next day. The surgery is performed through the oral cavity, leaving no scar on the face. The skeleton is secured with mini titanium plates and screws not allowing micromovement of bones. In post-surgery is normal to appear some swelling  which decreases after a few days.


What are the Post-Surgical Care?

* The food should be cold and soft.
* The use of ice decreases the swelling and should be used frequently during the first 24 hours.
* Strict compliance to prescribed medication.