Orthognathic surgery refers to the surgical correction needed to fix misalignment of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area and can result in significant functional impairments (difficulty with speech, eating, breathing, chewing, and/or jaw joint pain).

Orthognathic surgery (corrective jaw surgery) is generally performed by an oral and maxillofacial surgeon to correct a malocclusion (bad bite) in cases where routine orthodontic treatment alone has not or will not be effective. Orthognathic surgeries include movement of the maxilla (upper jaw), mandible (lower jaw) and chin into an ideal position.

Surgeries are typically performed in the hospital under general anesthesia. Your orthodontist will align the teeth into a proper position pre operatively and perform final touches post operatively. 

Reasons for orthognathic surgery

The misalignment of the jaws can create an unfavorable environment for your teeth, jaws, and face if left untreated. Problems that may arise include:

• Tooth Wear – In the case of an overbite (upper jaw ahead of lower jaw), the pressure and wear on the teeth is not spread evenly. This can also lead to Temporomandibular joint disorder (TMD), migraine headaches, and tooth loss.
• Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth and jaws can alter the way the facial muscles interact.  In some cases, the cartilage, which acts as a buffer between the jawbones, can be painfully damaged. 
• Loose Teeth – When uneven pressure is continually exerted in unintended places or soft tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain and reduces proper function.
• Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods are eaten.
• Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor alignment of the upper and lower jaws.
• Sleep Apnea and Chronic Mouth Breathing - When the maxilla (upper jaw) and/or the mandible (lower jaw) are too far back, this can lead to a constricted airway making you more prone to snoring, mouth breathing, or sleep apnea. 
• Unbalanced facial appearance - The upper and lower jaws greatly impact your overall facial appearance. When the jaws are misaligned it may give the appearance of excessively large teeth, the absence of a chin, or a flattened facial appearance. 
  

What does orthognathic surgery involve?

Your Oral Surgeon and Orthodontist will complete a photographic analysis, an analysis of dental models, panoramic and lateral cephalometric xrays and determine if you are an ideal candidate for corrective jaw surgery. They will discuss how this surgery will not only improve jaw dysfunction, but also how it will alter the aesthetic appearance of your face. 

Orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You will be required to maintain a soft non chew diet for a period of time after the operation.

Patients generally are not wired shut after the surgery and the surgery does not involve any incisions on the face which makes it as minimally invasive as possible!

Virtual Surgical Planning and Orthognathic Surgery 

Drs. Bianco and Singh utilize cutting edge technology to plan and execute your surgery. With the use of a CT scan, dental models, and photos, Drs. Bianco and Singh are able to create a virtual surgical plan to customized to your individual needs. Virtual Surgical Planning allows for the osteotomies (bone cuts) to be placed in an ideal position which then allows the jaws to be placed in the most accurate position.