A Guide to Orthognathic Surgery

Orthognathic surgery is the term used to describe the surgical procedures on the structure of the face and jaw. Orthognathic surgical procedures should not be confused with cosmetic surgery. Orthognathic surgery is designed to adjust the underlying structure of the face or jaw, not just to alter the appearance of the face. Therefore, it requires a specialist surgeon who is also trained in dentistry.

Orthognathic surgery is usually required to redress serious craniofacial anomalies. In fact, the name ‘orthognathic’ quite literally means ‘surgery to create straight jaws’. It can be used to correct facial deformities, facial asymmetry, eating and biting issues, cleft lips and even speech problems. Orthognathic surgery is therefore normally part of a much broader programme of treatment for a wide variety of issues.

Orthognathic surgery is performed by an oral and maxillofacial surgeon. This is a type of surgeon with specific skills in dentistry. However, the surgeon will often liaise closely with other specialists, such as the orthodontist or perhaps even a speech therapist. Depending on the patient requirements, it can involve a large team bringing a number of areas of expertise together.

Orthodontic work is often an important aspect of the overall programme. However, orthodontic treatment alone will only correct the patient’s bite. If the problem is with the underlying bone structure, then orthognathic surgery is required to move the jaw into the correct position. Only once this has been successfully done can the orthodontist start the process of moving the teeth.

The actual surgical process that is involved in orthognathic surgery is known as osteomies. Osteomies is the name given the technique whereby sections of the jaw are isolated and cut so that they can then be moved into the correct positions. In the past, the patient would need to have their jaw wired so that the moved sections remained in place. Modern techniques, however, mean that the jaw can now by held in place by smaller metal plates, which are far more discrete.

Patients will normally be required to remain in hospital for around five days. Once the surgeon is happy that the operation has been a success, your orthodontist will move your teeth into the correct position using a brace. In fact, the majority of patients will begin wearing their brace before the procedure begins and even continue wearing it throughout the operation. In this way, the teeth can begin to move and, once the jaw is in the right position, they can be brought into their final position.

How long you have to wear your brace after surgery will depend on how far your teeth need to be moved to reach their correct position. For some patients, it can be as short as a three-month period. For others, it can take as long as twelve months for the teeth to move successfully. It all depends on how severe the case is to begin with.

Orthognathic surgery is a very safe procedure that can make a real difference to how patient’s perceive themselves. Modern dental equipment means that the jawbone can be cut and moved easily and with great precision. After the procedure, you may find that you have some bruising and swelling around the jaw. However, this should subside quite quickly and your doctor will be able to prescribe antibiotics to reduce the swelling if required.

Once the procedure has been completed, it is more than likely that the patient will have a meeting with a dietician to talk about maintaining a healthy diet while their jaw heals. For the first few weeks or month, you will be restricted to a liquid diet. You should stick carefully to the diet your dietician prescribes. Your orthodontist will also give you clear instructions on how to care for your brace.

The effectiveness of your brace depends to a large extent on the patient. Regular visits to your orthodontist will be required so that he or she can maintain the tension of the brace so that it moves the teeth as efficiently as possible. Missed appointments may mean that it takes longer to move your teeth and that the treatment time is therefore extended.