Corrective jaw surgery, also known as orthognathic surgery, can fix both cosmetic and functional issues. Our jawbones, after all, determine how our teeth fit together… or why they don’t.
Often, due to a congenital condition or abnormalities of growth, one’s bite doesn’t match up. (You may hear your doctor talk about “occlusion”). For instance, one portion of the jaw might be too big or too small, causing an extreme over- or underbite. In extreme cases, malocclusion can make eating — biting and chewing — difficult or painful.
In extreme cases, misalignment of the jaw can affect one’s facial appearance. So in addition to restoring jaw and dental function, orthognathic surgery plays an important role in addressing cosmetic deficiencies.
Delayed Approach to Orthognathic Surgery
Corrective jaw surgery addresses a congenital conditions that, over time, have become unmanageable, uncomfortable, or which affects the patient’s appearance. In extreme cases, these conditions can also have an impact on emotional, psychological, and social health.
The first recommendation will almost always be braces. Most minor deformities can be treated or camouflaged in this way. Corrective jaw surgeries address only those problems that orthodontics cannot correct.
Except in life-threatening cases (such as Pierre Robin Sequence which can cause breathing problems in infants), most surgeons will prefer to wait until late adolescence to proceed. We do this because the bones of the jaw grow and our bite changes throughout early childhood.
A delayed approach allows the adult (or permanent) teeth to establish themselves. A delayed approach also assures persistent good results as the patient moves into adulthood.
Conditions Requiring Corrective Jaw Surgery
There are a range of adult conditions, both congenital and progressive, that may require surgical re-positioning of the jaw.
Sometimes it is a cosmetic issue that originated at birth. For instance, in many patients born with a combined cleft lip and palate, repair may affect the growth of the jaw, eventually requiring maxillary advancement (extension of the upper jaw). More frequently, orthognathic surgeries are a response to trauma or to progressive, painful conditions such as TMJ (temporomandibular joint pain).
Surgery is also an appropriate response to severe injury. Post-traumatic reconstruction of the jaw can restore both a patient’s bite and the structural integrity of the face.
Often, a skilled craniofacial surgeon can help balance the facial features, normalizing one’s appearance while at the same time alleviating pain and discomfort.
Virtual Surgical Planning® for Orthognathic Surgery
Advances in digital imaging and computer science provide us with an incredible range of tools.
At NOLA Craniofacial, we recommend Virtual Surgical Planning® as the most predictable aid to successful orthognathic surgery. Better planning means fewer surprises, fewer complications, and allows us to use minimally-invasive and other advanced techniques that produce a better, more predictable cosmetic result.
Virtual Surgical Planning® — high-resolution 3D imaging, special software, and the latest in 3D-printing — also allows us precision in fabricating the plates that hold the repair together. If the jaw must be extended, patient specific implants and/or microsurgical free-flap transfers allow the surgeon even greater flexibility in making a healthy, lasting repair.
Recovering from Corrective Jaw Surgery
As with most craniofacial surgeries, a team approach assures the very best results.
NOLA Craniofacial will work in collaboration with your orthodontist, which is often a matter of personal choice. In cases of orthognathic surgery following repair of partial or complete cleft palate, we work with specially-trained cleft orthodontists here in New Orleans.
For complex cosmetic reconstructions, we prefer to use extremely thin plates (composed of bio-inert materials) in order to secure the repair. Thanks to advances in materials science, these plates are so thin that they are not palpable. You cannot see or feel them with your fingers. Yet because of this, some patients will have to have their jaw wired for 2 to 4 weeks to protect the repair.
In almost all instances, braces are required both before and for a period of time following the surgery in order to fine tune the patient’s bite. While no additional devices are required (i.e. headgear), orthodontic care is an absolute must for optimal results.