The word orthognathic is composed of two parts that comes from the Greek: “ortos” in Greek means straight and “gnathos” means mandible or lower jaw. Nowadays, this surgery also includes the correction of the upper jaw.
Therefore it is the surgery that is dedicated to put in correct position and size these bones either lengthening it, shortening it or placing it in a different place, in relation to its base of the skull.
Physical and psychological consequences
This surgery is performed when there are disharmonies in facial growth, that is, when the maxilla and/or mandible grow more or less than they should in the three planes of space, producing as a consequence disharmonies in the soft tissue such as very prominent chins or just the opposite, flat faces without volumes, smiles in which there is a lot of gum, facial asymmetries and sleep apneas.
The teeth erupt in these jaws in such a way that the size and/or position is incorrect, the occlusion between the teeth is not adequate, producing irreversible dental lesions, joint pain and chewing problems.
All these physical problems, we could say, are irrelevant, compared to the psychic ones, since the patient suffers, from his early childhood and especially in adolescence, social rejection, in this society, where the aesthetic demands are increasingly greater, modeling a shy, introverted and insecure character.
During orthognathic surgery a correct alignment of the jaws is achieved, a correct occlusion, as well as facial harmony. When the jaws move three-dimensionally, the facial soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the arches are correctly positioned, facial harmony is acquired, which translates into a beautiful profile, a face with harmonious facial volumes, i.e. balanced and a great psychic change characterized by greater self-confidence.
Resorting to surgery
Previously, this type of patient was treated only with orthodontics. This method is called “orthodontic camouflage” because it usually improves chewing function slightly, but it does not correct the misalignment of the jaws and often the facial profile worsens and it is a very long orthodontic process with great risk of dental lesions. Fortunately, fewer and fewer orthodontists are willing to do this.
Nowadays, orthodontic treatment and surgical intervention are combined.
In all cases, treatment begins with pre-surgical orthodontics (approximately one year, although new surgical techniques allow this period to be reduced to a couple of months in many cases). Then the surgery is performed, which can be mono or bimaxillary, so that both arches are fixed in the new position, matching the correct occlusion with facial balance.
Orthodontic treatment will continue after surgery until all teeth end up in perfect occlusion with duration.
A minimum age
Orthognathic surgery is performed from the age of 18, when growth has usually stopped. It is rarely performed on younger patients, especially males. As women finish their growth earlier, it is sometimes possible to perform it.
Previously it was performed almost exclusively in the post-adolescence or in the beginning of maturity, but nowadays, this age profile is expanding since it is required by different specialties, for example the prosthodontist since for the correct placement of implants he needs a correct bone base for a later occlusal rehabilitation. Also the pulmonologist for his patients with sleep apnea since it is the only curative treatment that exists for this problem.