Orthognathic Surgery (Surgical Orthodontics) – For majority of people with misaligned teeth, braces alone are an ideal solution to align teeth and correct your bite. However, sometimes there is more to a problem that just misaligned teeth. Jaw growth is a gradual process and in some cases, the upper and lower jaws may grow at different rates. In these cases, patients develop a malocclusion in which their upper and lower jaws are not aligned. Causing a variety of different problems affecting the patient’s ability to chew, speak, breathe or sleep properly. Other factors such as injuries to the jaws or birth defects may also affect the jaw alignment. Jaw alignment may be so severe that affects the appearance of the patients smile or face. This can lead to a variety of different psychological or emotional problems as well.

Patients whose jaws are no longer growing and do not form a correct relationship, may need more than basic orthodontic treatment. Dr. Mir can correct occlusion or bite problems of such severity by a corrective procedure called Orthognathic Surgery to rectify the misalignment of the jaws. 

Orthognathic surgery is a surgical procedure that corrects jaw deformities by adjusting the position or length of the jaw. Once the teeth are set at their ideal position, an oral surgeon will move the bone of one or both jaws into the proper position in relation to the surrounding anatomy. This procedure is done so Dr. Mir can move forward with correcting the patient’s bite and teeth alignment. In majority of cases, orthognathic surgery is performed in conjunction with braces. Typically, braces are placed for up to 18 months prior to orthognathic surgery. In this time, Dr. Mir will do his best to align the teeth as much as possible before surgical realignment. Patients may notice their bite worsening prior to surgery. This is common as intentional worsening is required to align the jaws during the procedure. The surgeon may move the upper and lower jaw in almost any direction needed to correct the occlusion. This relatively extensive surgery is performed by an oral surgeon in your local hospital.

WHAT TO EXPECT

As your pre-surgery orthodontic treatment nears completion and prior to your surgery, your oral surgeon will conduct a thorough examination. This will include reviewing your medical history, taking a series of photographs and X-Rays, facial measurements, dental impressions and bite recordings. During this time, you will be able to ask your surgeon details regarding the procedure as well as pre and postoperative treatment.

The procedure may take 1-4 hours depending on the severity of your condition. In most cases, patients will be able to go home within the same day as their procedure. Generally, it takes upwards of 2 weeks before the patient is able to go back to school or work. However, the healing phase is approximately 6 weeks. Complete jaw healing can take anywhere from 9-12 months.

Corrective jaw surgery will be accompanied with increased swelling of the patient’s face. Postoperative pain is to be expected as jaw surgery is an extensive procedure. Dr. Mir encourages a liquid diet to avoid discomfort. In some cases, pain medication will be prescribed. If not, we recommend over the counter pain medication. Difficulty sleeping, eating and speaking is to be expected. Rest and a good diet is very important in the post operative healing stages.

TYPES OF JAW SURGERY:

CLASS II (“OVERBITE”) PROBLEM

Class II malocclusion occurs when one or both jaws grow inappropriately and cause an “overbite”. Majority of the time, orthodontic treatment alone can correct an overbite. But, in some cases, the overbite is so severe that it requires orthognathic surgery to correct the jaw deformities as well as orthodontics. In most cases, the problem is the underdevelopment of the lower jaw. Therefore, your oral surgeon will separate and reposition the lower jaw in a forward motion to correct the overbite. Once this is completed, the surgeon will secure the jaw with special biocompatible screws and plates, allowing the jaw to heal in the corrected position.

CLASS III (“UNDERBITE”) PROBLEM

Class III malocclusion occurs when one or both jaws grow inappropriately and cause an underbite. Similar to a mild overbite, when the underbite is caused by the position of the teeth, orthodontic treatment can correct this deformity. When the underbite it caused by the underdevelopment of the upper jaw or the excessive growth of the lower jaw, orthodontic treatment alone cannot correct this problem. In these cases, orthognathic surgery is required to correct the upper and lower jaw relationship. Your oral surgeon will either shorten the overgrowth of the lower jaw or lengthen the growth deficiency of the upper jaw. The surgical procedure involving the upper jaw is known as the LeFort Upper Jaw Surgery to bring the middle of the face forward. Your surgeon separates the upper jaw from the skull and moves it forward into the correct position.  Once the jaws are moved into the desired position, your oral surgeon will insert biocompatible screws and plates, allowing the jaw to heal in the correct position. This will improve the deficiency in the facial structures below the nose as well.

OPEN BITE PROBLEM

An open bite is a form of malocclusion in which the front upper and lower teeth do not come in contact with each other when the mouth is closed. If this is caused by inappropriate jaw growth, orthodontic treatment alone will not be able to correct the jaw deformities. Since one or both jaws could be responsible, correction of a skeletal open bite is different for every patient. Determining the site of where the surgery will be performed depends on diagnosis of the source of the growth problem. Your oral surgeon will remove parts of the bone in the tooth bearing portion of the jaw. Once done so, the surgeon will reposition the jaw to align properly. Once completed, screws will be secured to allow healing.

GUMMY SMILE PROBLEM

A gummy smile is when a patient’s upper gums are unusually visible when they smile. This is also known as excessive gingival display. There are a few factors that can cause a gummy smile including, overdeveloped muscle of the upper lip, upper lips and gums are joined too closely, and overdevelopment of the upper jaw in the vertical dimension. There are a variety of different ways to treat a gummy smile, depending on the severity. Orthognathic surgery may be recommended in a severe case where other methods are not an option. In this case, your oral surgeon will remove a portion of the upper jaw and secure it back in place with special screws, allowing it to heal in the appropriate location.

GOALS OF ORTHOGNATHIC SURGERY:

• Satisfy patients concerns
• Improve function
• Prevent wear and tear on teeth
• Enhance aesthetic appearance

ORTHOGNATHIC SURGERY IS A TEAM EFFORT:

• DENTIST: Ensures teeth and supporting structures are in good health
• ORTHODONTIST: Straighten teeth prior to surgery and refine the bite once healed.
• ORAL SURGEON: Reposition one or both jaws

If you believe you are a candidate for orthodontic surgery, or are experiencing any of the problems or symptoms listed above, please contact York Orthodontics for a complementary consultation at 289 588 8747 or visit our website at https://www.yorkortho.ca