Do not confuse orthognathic surgery with orthodontic therapy (braces). While Orthodontic treatment (braces) can correct many problems
if only the teeth are involved Orthognathic Surgery maybe required if the jaws (bone) also need repositioning.
When planning an orthognathic surgical case, the general dentist, orthodontist and oral surgeon will work closely with one another
to set the stage for optimum post surgical results in regards to both function and esthetics.
Ortho means straighten and gnathia means jaw and hence, orthognathic surgery means straightening of the jaw(s) by surgery.
An Oral & Maxillofacial Surgeon practices orthognathic surgery.
The conditions which require orthognathic surgery are often refered to as “bad
bites”. There are many types of “bad bites”, with some
having a greater effect on facial esthetics than others. The
common maxillofacial deformities and their clinical
appearances are the following:
1. Protruded Maxilla (upper jaw) :
The upper jaw is protruded beyond the normal limits along with the
teeth. The person cannot close his lips (lip incompetence)
without effort. The teeth are always visible and in most
cases the whole of the gums are visible on smiling (gummy
smile). A gummy smile is mainly due to the vertical excess
of the maxilla.
2. Retruded Maxilla :
This deformity is due to under development of the upper jaw
mainly seen in people who have cleft lip or palate. After
the surgical correction of the cleft lip or palate at a
young age the growth of the maxilla is retarded along with
displacement or destruction of the tooth bud. This causes a
dish shaped face with a hooked or flaring nose and
irregularly aligned, rotated or missing teeth.
3. Protruded Mandible (lower jaw) :
In some people there will be extra growth of the lower jaw
resulting in long jaw. Their faces are very long with
protrusion of the lower teeth and thick lips. Normally on
biting the lower teeth will be inside the upper teeth while
in people with long jaws usually the lower teeth will be
outside the upper arch.
4. Retruded Mandible :
In some people due to developmental deformity or due to
hereditary factors the lower jaw is very small resulting in
a “bird face”. There is no proper development of the chin.
5. Facial Asymmetry :
Sometimes a part of the face maybe overdeveloped or
underdeveloped causing one part of the face to be small or
large. One side of the face is not in symmetry with the
other side giving an unaesthetic appearance.
6. Akylosis of Tempromandibular Joint (TMJ) :
Injury during birth or trauma or infection at a young age
to the tempromandibular joint will result in restricted
mouth opening and reduced growth of the mandible.
7. Nasal Deformity :
Nasal deformities are often seen along with deformities of
the jaw. Some common deformities of the nose are: deviated
nasal septum, flared or constricted ala of the nose, saddle
nose, hooked nose, asymmetrical nose, etc.