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June 2012
Orthognathic Surgery: A Change In Persona
Dr G Vijay Reddy & Dr N Vivek Vardhan Reddy
Hereditary factors, injury and disease can sometimes mean certain deformities in the maxillofacial structure. Some of these are progressive, giving an off-balanced look and shape to the face, and leading to functional problems of the jaws and teeth.

The shape of your face and the functional discrepancies therein can be addressed by a corrective surgical intervention called Orthognathic Surgery.

The word “orthognathic” comes from Greek words orthos, meaning straight, and gnathos, meaning jaws. Orthognathic surgery shapes your Orthognathic Surgery: A Change In Persona face by straightening your teeth with orthodontics and repositioning your jaws with corrective jaw surgery. An orthognathic team consists of an orthodontist (a dentist who specialises in straightening the teeth) and an oral and maxillofacial surgeon specially trained in jaw surgery.

Facial Imbalances
If your jaws and face are out of proportion because of the uneven development of your jaws early in the growing period, or because of an injury to the face, then it may result in uneven or misaligned jaws. Uneven jaws may be characterised by an underdeveloped or overdeveloped lower jaw or upper jaw or an uneven jaw/facial asymmetry with underdevelopment on one side and overdevelopment on the other, or a gummy smile or some of your teeth may not meet, making chewing difficult.

Who Benefits From Orthognathic Surgery?
  • People with problems in biting and chewing food.
  • People with unbalanced facial shape/appearance.
  • People with facial injuries or birth defects.

Surgery And Preparation For The “New you”!
The orthodontist and surgeon work together to evaluate your teeth and bones and the extent to which they have to be removed.

Once the evaluation is completed, the orthognathic team may prepare a treatment plan by tracing your new profile. According to the established treatment plan, the orthodontist uses braces to position your teeth for the bite you will have after surgery. This may seem like your braces are making your bite worse than it was before!

The surgery is scheduled once the teeth are set in the correct position. During surgery, the bones are repositioned. These realigned or repositioned bones heal within a few months. To aid in healing, your bones are kept from moving with fixation appliances. Your surgeon may choose screws, plates, wires, or a combination. A splint may also be used to temporarily secure your bite. Screws and plates are usually not removed.

Your Road To Recovery (3-6 months)
At first you may look different, and that is obviously because your face is swollen and your jaw has moved. But it won’t be long before you see your face take its new shape. It takes six months to a year to make sure your teeth are in the correct position for your new,
readjusted jaw.

Finishing Touches
To secure your corrected teeth in position, you may have to wear a positioner or retainer. A positioner is a flexible plastic mouthpiece that guides your teeth into their final position and exercises your jaw muscles. A retainer is a combination of a wire and hard plastic that holds your teeth in place.

Risks And Complications
As with any surgery, this too has some risks and complications. You may experience some pain and swelling in your face and neck, but most of it is usually gone within a couple of weeks. Your face may feel stiff or numb for several months. The surgeon will discuss these risks and complications with you before surgery.

Additional Cosmetic Surgeries
Many people consider additional cosmetic surgeries on eyes, nose, chin, or neck to enhance their new look. By working with a highly skilled orthognathic team, you can have your teeth and bones in the jaw moved to a more balanced and functional position. You may be pleasantly surprised at the difference it makes to how your face looks and feels.

Treatment Duration
The total duration of your treatment may range from 18 months to two years.
The phases of treatment are:
  • Preparation/braces on: 6 to 12 months
  • Surgery
  • Recuperation/braces off: 3 to 6 months

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