Sometimes you can't correct your teeth and how they bite together by only using orthodontics. This is because the bones of your face and jaws where teeth sit, may be out of balance with one another.
Orthognathic surgery is an operation to repostion the jaws. It aims to correct imbalance between the upper and low jaws which enable the teeth to bite together correctly and also achieves a balancing and enhancing the facial appearance.
However it is important to use braces to move the teeth to make sure they will meet together correctly after the opperation. Usually, fixed ‘train-track’ type braces are fitted about 18 months before surgery. They are worn for about 6 months afterwards until the teeth are finely adjusted and supported. Lastly, a removable retainer brace is worn that holds the teeth in their new position.
Orthognathic surgery: Am i suitable?
if you are unhappy with a large, small or asymmetrical lower or upper jaw, your profile or wish to enhance or reduce the side of your chin then this could be the treatment for you.
A consultantion as usual is necessary to know whether your a suitable candidate.
Orthognathic surgery: What is the treatment like?
In total, treatment may take about two and a half years, with the surgery about 18 months from the start of orthodontics.
There are no external scars. On very rare occasions the surgeon may need to make a 2mm cut on the angle of your jaw, but this is usually virtually invisible a few weeks after surgery. The jawbones are repositioned and secured by tiny plates and screws, which remain under the gum. The teeth are not normally wired together but small elastic bands are used between the top and bottom brace to guide the teeth into their new bite.
Orthognathic surgery: What about after?
Most patients stay in hospital for one or two nights after surgery. People vary in their speed of recovery, but you should consider taking between two and four weeks off from work.
The main problem after surgery is numbness and swelling rather than pain, and the combination of numb lips and swelling makes the swelling seem worse than it actually is. Most patients find the swelling is at its worst 36-48 hours after the surgery and it gradually goes down over the next two weeks.
Your final appearance takes several months to fully emerge as the shape of your face adjusts. You may find it uncomfortable breathing through your nose and may have a sore throat after surgery and most feel uncomfortable for a few days. Older patients seem to find these symptoms worse and take longer to get over the operation than the younger patients.
Your mouth will open and close normally, even on the day of surgery, but the opening is limited by the elastic bands and swelling. You will be encouraged to eat and drink from the first day and gradually progress from soft, mushy food to a normal diet over the next few weeks.
Orthognathic surgery: Are there any risks or side effects?
It's usually a very safe procedure if carried out by a specialised and experienced practitioner. 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.
Numbness - Your lips will be numb immediately after the operation. The upper lip recovers quickly. The lower lip may take 6-9 months to get its normal feeling back. Very rarely sensation never completely returns.
Infection - The tiny fixing plates are usually left in place permanently. However in rare cases, the plates may have to be removed if they become infected but this is usually after they have done their job.
Re-adjustment of the bite - In rare cases the bite may require adjusting. This sometimes happens when the patient wakes up from the relaxed state of the anaesthetic and the strong jaw muscles move the bite. Although the bite may only be a few millimetres out of place, a second operation to adjust the plate fixation may be needed.
Relapse of the operation - With most patients significant relapse is not a problem. However those who are having movements of 10mm or more in one jaw,previously had a cleft palate, or have a unusual bitea, relapse can occur. If relapse does occur, it is exceptionally rare for this to be significant.
Orthognathic surgery: What will it cost me?
It completely depends on the case and where you get it done, on avaerage it can be from £12,000 up to £24,000.