Orthognathic surgery (a term that comes from the Greek orthos (right) and gnathos (jaw)) aims to move the teeth and bones to a more appropriate, more esthetic, more functional and, of course, healthier position. This is achieved through the combination of two areas or medical-dental specialties: orthodontics and maxillofacial surgery.
Orthodontics moves teeth and maxillofacial surgery moves bones. Dentofacial deformities are very frequent; between 8 and 12% of the world’s population presents some type of imbalance related to the teeth. We are talking about patients with an inadequate bite (malocclusion), or those in which the bones are in an incorrect position.
Malocclusion
A malocclusion is any degree of inadequate contact between the teeth of the upper jaw and those of the lower jaw. Thus, a malocclusion can cause problems with the bite, gingival tissue, jaw articulation, phonation and esthetics.
Dentofacial alterations
- Difficulty in chewing, biting or swallowing.
- Difficulty in speaking or pronouncing certain words
- Pain or sounds in the TMJ
- Pain or muscular alterations in the neck and/or face
- Psychological disturbances
- Breathing difficulty
- Ear pain
- Snoring or sleep disorders
How to correct dentofacial alterations with orthodontics
Orthodontics is the specialty of dentistry that deals with the diagnosis and correction of malposition of the teeth, aligning them and placing them in correct positions, improving the bite, chewing function and facial aesthetics. If the inadequate position of the teeth is added to the poor development of the mandibular and/or maxillary bones, it is necessary to combine this orthodontics with corrective surgery or orthognathic surgery.
During childhood, certain malocclusions or dentofacial disharmony can be treated simply by orthodontics and growth forces, but in adulthood there is no such possibility.
Orthodontics can correct bite problems when it affects only the teeth, while orthognathic surgery is necessary when there is a skeletal imbalance of the maxillary or mandibular bones.
How to correct dentofacial alterations with orthognathic surgery
Orthognathic surgery is performed in order to place the bones in their proper position after initial orthodontic or pre-surgical treatment. Its main objective is to achieve a proper bite, restore masticatory function and improve facial esthetics.
Why should I resort to orthognathic surgery?
There are several reasons why these dentofacial disharmonies should be corrected:
- When orthodontic treatment alone cannot correct the problem.
- When dental malposition is associated with aesthetic problems or moderate or severe alterations. These disharmonies have great influence on facial aesthetics, so one of the main benefits is to improve the appearance.
- Improving the masticatory function will not only improve chewing, but also avoid occlusal imbalances or dental overloads, which result in pain, tooth loss…
- Sometimes orthodontics alone achieves good results, although sometimes they have to be corrected with surgery.
- To reduce orthodontic time. Mobilizing the bones to a better position facilitates orthodontics and reduces treatment time.
- Favorable aesthetic changes, since surgery improves the patient’s facial aesthetics.
- Improved breathing
- Improved speech
- Improve and possibly avoid TMJ disorders.
What are the most frequent dentofacial alterations?
- Large jaw: the person has an oversized jaw, and his lower teeth bite in front of the upper teeth.
- Small mandible: anteposterior deficiency of the mandible. The jaw is undersized, the upper teeth completely hide the lower teeth, the chin is very small, and the chin is close to the neck.
- Long face: the lower third of the face is very long, making it impossible for the patient to close the lips and constantly showing teeth. At the same time, the gums are exaggerated when the patient smiles.
- Old man’s face: the middle third of the face is flattened in the area of the cheeks and upper lip, looking as if the jaw was large, although in reality it is of normal size. The teeth are hidden and are not visible when smiling, the nose being downward and very prominent.
- Facial asymmetry: the face is uneven, the midline of the face and teeth do not match, they are not aligned, one side of the face is larger, wider or longer than the other, the mouth is crooked or the chin is on one side, and the bite is crossed on one side.
- Open bite: the person cannot bite with their teeth in the front portion of the mouth, the upper teeth do not touch the lower teeth. This is mainly due to parafunctional habits such as thumb sucking or poor tongue position when swallowing.
For more information consult a specialist in Oral and Maxillofacial Surgery.