When to resort to Orthognathic Surgery

Facial disharmonies can be the result of an alteration in craniofacial development, genetic causes, facial trauma… all these factors have an adverse effect on how the jaws and teeth end up relating to each other.

The reason for the patient’s consultation may be either to achieve a different esthetic or to improve the function that is not being performed correctly.
The first thing that should be done in these patients is a good examination and planning of the case as a team of orthodontist and surgeon. This examination is mainly based on facial analysis. Aesthetics has been valued since ancient times, Egyptians, Romans, Renaissance… beauty has been important in the sense of the need of all times and cultures to seek an ideal and a standard and most wish to be similar to this standard. This norm or ideal changes according to the times and cultures. Patients with some disharmony want that, to be similar to the norm, “to be normal”. Surgery allows this facial change since it repositions the bones in their ideal position, achieving a good facial aesthetic harmony while restoring function.

The second objective of this treatment is to obtain a correct dental function, (“I do not chew correctly”). The occlusion is important for a correct function, the incisors must be able to make the cut with the anterior teeth, this is called a protrusive. The canines protect the lateral movements while chewing and the molars should contact with all the teeth during chewing. The orthodontic appliances and the management of the placement of the teeth by the orthodontist allow this functional objective to be achieved. The objectives of a correct facial aesthetics, dental aesthetics and correct occlusion that favors the health of the temporomandibular joints and the health of the periodontium or gums are achieved.

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A final objective to be achieved is the aid to breathing. Both some patients without dentofacial alteration and many of these patients with dentofacial alteration breathe incorrectly, they present a sleep apnea syndrome due to narrow airways. The Sahos, or sleeping sickness is one of the most worrying pathologies, not resting well and having low oxygenation, the patient falls asleep and does not respond perfectly to their daily active rhythm. Orthognathic surgery, with the forward movement of the bones, provides a wider airway that enables the patient to live a more comfortable life, without needing a negative pressure appliance, CPAP, or a mandibular advancement device, MAD, in order to live adequately.