Orthognathic surgery is an operation to reposition the jaws. (Ortho means straighten, gnathia means jaw in Latin). The operation aims to correct imbalances between the upper and lower jaws.

It is not always possible to correct your teeth and acheive the bite using only orthodontics (braces). This is because the bones of your face and jaws, in which the teeth are positioned, may be out of balance with one another. (For example, you may have a larger lower jaw and a normal sized upper jaw).

It is not always possible to correct your teeth and acheive the bite using only orthodontics (braces). This is because the bones of your face and jaws, in which the teeth are positioned, may be out of balance with one another. (For example, you may have a larger lower jaw and a normal sized upper jaw).

Orthognathic surgery is able to correct larger jaw discrepancies and improve both the bite of your teeth as well as your appearance by altering the shape of the face.

Why do I need Orthognathic Surgery?

• Do you have any difficulty in chewing or biting?
• Dont you like your facial appearance from the front?
• Dont you like your facial appearance from the side?
• Do you have a protruding jaw or no chin?
• Do you have an open bite?

What is the First Step?

The first consultation is a very important part of your treatment. It is an opportunity to meet the team consisting maxillofacial surgeon and orthodontist.

Your doctor will assess your expectations and also establish the diagnosis. They will take photos, dental impressions for study models, x-rays or CT scans needed to assess your case.

If your condition warrants surgery then this will be explained to you about the realistic outcome, the required time frame and also any risks involved.

It is normal to need orthodontic treatment before as well as after the surgery. It is important to use braces to move the teeth to make sure that they will meet together correctly after the operation.

How is orthognathic surgery performed?

The surgery may be limited to either the upper or lower jaw or in some cases both jaws (bimaxillary osteotomy).

In the vast majority of cases all surgery is all done from inside the mouth, so there are no external scars. The jawbones are repositioned and secured by tiny plates and screws made from pure titanium, which remain under the gums and are not seen in the mouth. Immediately following the surgery the teeth are not normally wired together. Small elastic bands are placed between the top and bottom braces to guide the teeth into their new bite after a day or so.

LE FORT 1 OSTEOTOMY

Which type of anaesthetic will be used?

Surgery will require a general anaesthetic which will involve admission to a Hospital.

Preparing to have your surgery

Your surgeon will explain how to prepare for your procedure. For example,

• if you smoke, you will be advised to stop as this significantly increases your risk of wound infection, slowing your recovery.
• Some types of medication you take may also require special consideration.
• Since you are having a general anaesthetic, you will be asked to follow fasting instructions, this means not eating or drinking for some hours prior to the procedure. You will be given specific instructions by the hospital prior to your admission date.
• Most patients will remain in hospital for 2 nights and you should probably plan to be away from work for two weeks after you are discharged from hospital.

Recovery from the Surgery

• After the operation you will have some swelling and bruising. This will rapidly begin to subside over the first 2 – 3 weeks.
• For operations on the lower jaw it is fairly common to have some numbness of the lower lip for some weeks or months afterwards. In a very small number of cases a residual area of numbness will remain. This numbness will not affect movement of your lip.
• However patients recover at different rates. It takes around 4-6 weeks for the total bone healing and 3-4 months for the facial muscles to get adapted.

Risks & Complications

This is usually a very safe procedure which is carried out regularly by specialised and experienced surgeons at Sree Dental. Complications in this type of surgery are, fortunately, rare and may not apply to you but it is important that you are aware of them. These may include:

Numbness – At times the lips will be numb immediately after the operation, similar to the sensation of an injection of local anaesthetic at the dentist. Very rarely sensation never completely returns. (The lip still looks and moves normally and only exceptionally does it bother patients).

Infection – The tiny fixing plates are usually left in place permanently. In less than 10% of cases the plates may have to be removed if they become infected

Re-adjustment of the bite – In rare circumstances the bite may require some more adjustments

Relapse of the operation – With most patients significant relapse is not a problem. However those who are having complicated surgery (movements of 10mm or more in one jaw, patients previously having had a cleft palate, or those with a particularly unusual bite) a relapse can occur. If relapse does occur, it is exceptionally rare for this to be significant. Your Consultant will discuss the risks that are specific to yo