What is Orthognathic Surgery

Orthognathic surgery is the branch of maxillofacial surgery that focuses on the correction of facial deformities and disproportions that have a skeletal etiology. These abnormalities can result from genetic factors, injuries or other diseases and affect the function and aesthetics of the face. The purpose of orthognathic surgery is to restore the correct position of the jaws and improve the occlusion of the teeth, ensuring natural and functional facial anatomy.

What are the Goals of Orthognathic Surgery?

Orthognathic surgery has as its main objective the correction of anatomical and functional abnormalities of the jaws and face, with the aim of restoring the harmony and normal function of the mouth and face. The main objectives of orthognathic surgery include:

• Restoration of functionality: By correcting the occlusion of the teeth and the anatomy of the jaws, the proper function of the mouth for chewing, swallowing and speaking is restored.
• Aesthetic restoration: The improvement of the appearance of the face, by correcting the abnormalities in the harmony and symmetry of the jaws and face.
• Improving breathing: By correcting occlusion problems that may affect the flow of air and cause respiratory problems, such as mouth breathing.
• Relief from pain and dysfunction: Restoring normal temporomandibular joint structure and function can relieve pain and tension caused by dysfunctions of these areas.

Who does Orthognathic Surgery concern?

Orthognathic surgery mainly concerns people who have anatomical abnormalities in the jaws or face that affect both the aesthetics and functionality of the mouth and face. More specifically, the categories of patients who may benefit from orthognathic surgery include:

• Patients with anatomical abnormalities in the jaws: When the jaws do not develop properly either due to heredity or other factors, patients experience occlusion problems that may affect the function of the mouth (chewing, swallowing, speaking) or the appearance of the face. These abnormalities may include underdevelopment or excessive development of the upper or lower jaw.
• People with injuries to the face or jaws: Patients who have suffered serious injuries or accidents (e.g., fracture of the jaw or face) and require surgical reconstruction to restore normal anatomy and functionality of the mouth.
• Patients with Temporomandibular Joint (TMJ) Disorders: People who suffer from chronic pain or dysfunction in the joints that connect the lower jaw to the skull (temporomandibular joint) may need orthognathic surgery to restore proper function and relieve symptoms.
• Patients with severe facial asymmetry: When the jaws develop unevenly, the face can appear markedly asymmetrical. Orthognathic surgery can correct the imbalance and improve the aesthetic appearance of the face.
• People with respiratory problems due to maxillofacial abnormalities: In cases where the jaw abnormality affects airflow and causes mouth breathing or respiratory problems, orthognathic surgery can help restore normal breathing.
• Patients with failed previous dental or orthodontic treatments: In some cases, patients may have undergone previous dental or orthodontic treatment without achieving the desired result. Orthognathic surgery can offer a solution to these patients, correcting problems that could not be resolved by other methods.

Orthognathic Surgery Procedure

The orthognathic surgery process includes a series of steps that depend on the extent of the problem and the patient's needs.

Preoperative Planning

The preoperative phase is extremely important and involves several steps to ensure that the surgery will have the best possible outcome. The main factors in preoperative planning include:

• Patient Assessment: Before surgery, the patient undergoes a complete clinical evaluation. This includes:

• Patient medical history
• Physical examination of the face and jaws
• X-rays and CT (computed tomography) to visualize the jaws and temporomandibular joint
• Evaluation of oral function (teeth clenching, chewing, speaking, etc.)
• Advice from an orthodontist for orthodontic preparation (in many cases required).

• Orthodontic Preparation: In many cases, the patient will need to undergo orthodontic treatment (usually for several months) to align the teeth and prepare the mouth for surgery. Orthodontic treatment helps to create the proper space for the jaws and align the bite.

• Surgical Intervention Plan: The oral surgeon, in collaboration with the orthodontist, will plan the operation. This includes:

• Choosing the type of operation
• Determining the position in which the bones will be placed after the surgical intervention

Postoperative Course

The postoperative phase is extremely important for the patient's recovery and the success of the operation. The recovery process includes several stages, from post-operative care in the clinic to full recovery.

Immediate Postoperative Recovery:

• Immediately after the operation, the patient remains under observation in the clinic for a few days, depending on the case.
• Painkillers and anti-inflammatory drugs are used to control pain and inflammation.
• Slight edema (swelling) and bruising around the face are common and disappear within the first few days.

Home Care and Recovery:

• The patient is asked to follow specific instructions to ensure proper recovery, such as:
• Consuming soft foods for the first time.
• Avoiding physical exertion or intense exercise.
• Meticulous oral hygiene care with special tools and avoiding the area of ​​surgical incisions.
• Usually, restriction of oral movement is required for the first few weeks, while there may be limitations in speech and chewing.

Long-term Recovery and Rehabilitation:

• Full recovery can take several months, depending on the extent of the surgery.
• In many cases, further orthodontic treatment is required to stabilize the dental occlusion.
• Gradual return to normal activities and improvement in oral function and facial appearance are observed over time.

Conclusions

Orthognathic surgery offers an excellent solution for patients with jaw abnormalities, improving facial aesthetics and functionality. When performed by a skilled maxillofacial surgeon, the procedure can provide excellent results, restoring facial harmony and improving the quality of life of patients.