Orthognathic Surgery

Orthognathic surgery is to correct conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders or to correct orthodontic problems that cannot be easily treated with braces. Originally coined by Dr. Harold Hargis, D.M.D., it is also used in treatment of congenital conditions like cleft palate. Bones can be cut and re-aligned, held in place with either screws or plates and screws

Planning

Planning for the surgery usually involves input from a multidisciplinary team. Involved professionals are Oral and Maxillofacial surgeons, Orthodontists, and sometimes a Speech and language therapist. As the surgery usually results in a noticeable change in the patient’s face a psychological assessment is occasionally required to assess patient’s need for surgery and its predicted effect on the patient.

Radiographs and photographs are taken to help in the planning and there is software to predict the shape of the patient’s face after surgery, which is useful both for planning and for explaining the surgery to the patient and the patient’s family. Advanced software can allow the patient to see the predicted results of the surgery

The main goals of orthognathic surgery are to achieve a correct bite, an aesthetic face and an enlarged airway. While correcting the bite is important, if the face is not considered the resulting bony changes might lead to an unaesthetic result. Orthognathic surgery is also available as a very successful treatment (90-100%) for obstructive sleep apnea. Great care needs to be taken during the planning phase to maximize airway patenc

Complications

Like any other surgery, there can be some complications like bleeding, swelling, infection, nausea and vomiting. There could also be some numbness in the face due to nerve damage. The numbness may be either temporary, or, more rarely, permanent. In general, complications of this surgery occur, but not frequently

If the surgery involved the upper jaw, then the surgery could have an effect on the shape of the patient’s nose. This can be minimized by careful planning and accurate execution of the surgical plan. Sometimes, this is considered part of the benefit

Root canal (some teeth have more than one root canal) treatments are sometimes required after surgery, especially when the surgery involves a maxillary osteotomy. In recent years, techniques have been created that may help reduce the need for root canal surgery, however, it is still a common complication that can occur

Post Operation

After orthognathic surgery, patients are often required to adhere to an all-liquid diet. After sometimes, soft food can be introduced, and then hard food. Diet is very important after the surgery, to accelerate the healing process. Weight loss due to lack of appetite and the liquid diet is common, but should be avoided if possible. Normal recovery time can range from a few weeks for minor surgery, to up to a year for more complicated surgery

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