Orthognathic surgery: the definitive solution against malocclusion

What does this surgery consist of?

Orthognathic surgery is the surgery that corrects dento-cranio-facial deformities, reestablishing the balance between the maxillary bones, restoring facial aesthetics and achieving correct mastication.

This procedure is performed by a maxillofacial surgeon assisted by an anesthesiologist, who is in charge of applying general anesthesia. It usually requires two days of hospitalization.

It is performed through incisions from inside the mouth that serve to reposition and adjust the jaws. In this way the dental malocclusion is solved and at the same time facial symmetry is restored. The bones are fixed with titanium plates and screws.

When is it necessary?

It is indicated whenever the origin of the malocclusion is osseous, i.e. the problem is caused by the position or dimension of the maxilla and/or mandible, resulting in facial alterations, such as significant asymmetries. In this type of case the correction involves a combined treatment of orthodontics and orthognathic surgery.

Coordination between the orthodontist and the maxillofacial surgeon is important to establish exactly what corrections are to be made to the teeth and bones.

The combined treatment consists of two phases:

  1. A first orthodontic phase in which the teeth are aligned within their bony base and the arches are made compatible with each other. It is usually necessary to extract the wisdom teeth. This phase lasts approximately a year and a half, although it varies according to each case.
  2. Orthognathic surgery is then performed to coordinate the maxilla and mandible. Both bones are usually operated on to ensure a correct restoration of facial volumes, although there are specific cases in which only the maxilla or mandible will need to be operated on. The second phase of orthodontics serves to completely adjust the gearing between the teeth and perfect their alignment. It does not usually take longer than 6 months.
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What to do after the procedure?

The patient will remain in the hospital for 24-48 hours after the operation, where he/she will be monitored by medical personnel. When he/she is discharged from the hospital, he/she must follow the instructions given by the surgeon. The most common are:

  • Soft diet (creams, soups…).
  • Sleeping with your head elevated.
  • Use of ice packs to reduce inflammation.
  • Use of medications (painkillers and anti-inflammatory prescribed by the doctor).
  • Wearing elastic bands between the maxilla and mandible.
  • Keep the mouth clean with proper brushing and rinsing.

The estimated recovery period is between 5-8 weeks depending on the type of intervention. Afterwards, the patient will gradually return to his or her normal routine.

For what pathologies is this surgery indicated?

It is used to treat alterations such as open bite, class II, class III, gingival smile due to maxillary vertical excess, etc.

These anomalies begin to develop in the growth phase of the patient and when this growth is completed they stabilize. For this reason, surgery is indicated for when the patient is in the adult phase and has finished growing.