I just want to straighten my teeth, why did the doctor ask me to have orthognathic surgery?

This is the 3050th article of Da Yi Xiao Hu

I believe that friends who have read the previous issue of "Dental Companion" have a certain understanding of orthodontic treatment. But some friends may still have a question: Why do orthodontists sometimes recommend orthognathic surgery? So what is orthognathic surgery? What is the relationship between orthognathic surgery and orthodontics? When do you need orthognathic surgery......

First, let's take a look at a case of orthodontic-orthognathic combined treatment completed by the Affiliated Stomatological Hospital of Tongji University. We can see that after two years of treatment, the girl's previous convex face has changed to a straight face, and a beautiful chin has appeared. The girl's appearance has been greatly improved, and this improvement cannot be fully achieved by correcting teeth alone. Through X-rays, we can see that she also underwent orthognathic surgery. Today, the editor will talk with you about a common situation in adult orthodontic treatment - orthodontic-orthognathic combined treatment.

1. Why do we need orthodontic-orthognathic combined treatment?

Answer: In our orthodontic treatment, we only change our teeth. However, if we adults encounter severe skeletal malocclusions (i.e., dentofacial deformities) such as overbite, buck teeth, protruding mouth, small mandible, open bite, and offset jaw, orthodontic treatment alone cannot achieve a good treatment effect. At this time, we need to use surgical methods to assist in the treatment in order to achieve better results. We call the discipline that mainly studies and treats dentofacial deformities orthognathic surgery. Generally, dentofacial deformities require orthodontic treatment plus orthognathic surgical treatment. This combined treatment method is called combined orthodontic and orthognathic treatment.

(Picture from the Internet)

2. What is orthodontic-orthognathic combined treatment?

A: In the treatment of severe maxillofacial deformities, different jaw osteotomy and movement surgical methods are used to correct the severely uncoordinated relationship between the upper and lower jaws, and orthodontic treatment is used to correct misaligned teeth, adjust the uncoordinated dental arch and jaw relationship, eliminate jaw interference, and align the teeth. The two are combined to treat severe maxillofacial deformities. This treatment method is called orthodontic-orthognathic combined treatment.

Among them, common orthognathic surgery procedures include maxillary Lefort I osteotomy, maxillary subapical osteotomy, mandibular ramus sagittal splitting, mandibular subapical osteotomy, genioplasty, mandibular angle correction, etc. Different procedures are selected according to different situations. Some patients with severe skeletal malocclusion in both the upper and lower jaws require two or more procedures for surgical treatment.

3. What is the timing of orthodontic-orthognathic combined treatment?

A: Orthodontic-orthognathic combined treatment is generally performed after growth and development are completed (growth and development are basically completed after girls are 18 years old and boys are 20 years old). If the following conditions exist, early surgical treatment can be considered:

① Patients with growth and development deficiency

② Patients with congenital malformations that affect normal development

③ Some patients whose growth is excessive but seriously affects their mental health and social behavior

4. What is the process of combined orthodontic and orthognathic treatment?

A: The process of orthodontic-orthognathic combined treatment is generally as follows:

① General condition assessment: including the patient’s basic condition, health status, family history, medical history, medication history, basic oral and maxillofacial condition, etc.

② Comprehensive oral treatment of periodontal and dental diseases: All periodontal diseases and dental diseases must be completed before orthodontic-orthognathic combined treatment.

③ Preoperative orthodontic treatment: mainly through wearing braces, moving teeth, and removing tooth compensation, so as to facilitate the movement of bone blocks in orthognathic surgery.

Preoperative orthodontic decompensation for mandibular protrusion

④ Orthognathic surgical treatment: It requires the participation of orthodontists, orthognathic surgeons and patients. According to the patient's request and basic condition, a suitable surgical plan should be formulated, and sufficient communication should be carried out with the patient (including treatment costs, treatment time, treatment effects, surgical risks, etc.) to finally determine the appropriate surgical treatment plan.

⑤ Postoperative orthodontic treatment: further orthodontic fine adjustment of the occlusal state. Mainly including elastic traction between the upper and lower jaws, postoperative alignment of the teeth, closing of the remaining space after surgery, etc. Postoperative orthodontic treatment usually takes half a year to one year to ensure the stability of the jaw after surgery, which is conducive to the long-term stability of the jaw deformity after correction.

Postoperative maxillomandibular traction

5. How long does it take to recover after orthognathic surgery?

A: The hospital stay is usually about 10-14 days. The recovery after surgery is usually 2-4 weeks. Usually, the patient can recover within one month after surgery.

You can resume normal work and study.

6. Will there be scars after orthognathic surgery?

Answer: Orthognathic surgery is performed inside the mouth. There will be no scars on the face and it will not affect the appearance.

7. Is orthognathic surgery a plastic surgery?

A: Orthognathic surgery is a type of plastic surgery. Orthognathic surgery can correct facial deformities caused by severe disharmony between the upper and lower jaws. This will greatly improve the appearance of patients undergoing orthognathic surgery, and the effect is natural. In addition, orthognathic surgery usually requires genioplasty, mandibular angle and lower edge trimming, bone grafting, etc. to improve facial contours and achieve cosmetic results.

Well, today’s small popular science about orthodontic-orthognathic combined treatment ends here. Dear friends who love beauty, if your orthodontist recommends you to have orthognathic surgery, don’t be afraid, actively cooperate with the orthodontist and orthognathic doctor, develop a surgical plan that suits you, and meet a more beautiful self!

Author: Liao Chongshan, He Jiangfeng