Information on Orthognathic Surgery

www.drvaibhavshah.net

Vaibhav Shah 

What is Orthognathic Surgery?

               Orthognathic surgery (Greek “orthos” means straight and “gnathos” means jaw) is a single or double jaw surgery which is performed to reposition the jaws. During orthognathic surgery a correct jaw alignment and occlusion, as well as, facial harmony is achieved. When the jaws are moved forwards or backwards, up or down, or rotated, the facial soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the jaws are correctly positioned a harmony between the facial features is acquired which results in a beautiful profile.

*Why do we need Orthognathic Surgery?

             Malocclusion impedes jaw function and does not allow proper chewing of food. If there is no adequate contact between upper and lower teeth, grinding of food is insufficient. This might exert negative influence on food digestion and overall body health. Moreover, crowding of teeth facilitates accumulation of food debris and aggravates maintenance of oral hygiene, therefore, teeth are more likely to be affected by dental caries or periodontal disease. Due to malocclusion teeth may wear out faster than usually and the lifetime of dental prostheses may shorten.

           Severe skeletal malocclusions caused by jaw mismatch in size and position may cause serious problems. For example, extremely small lower jaw may result in snoring and sleep apnea, which can consequently cause many health problems. In cases of short upper lip and vertical excess of the upper jaw, the lips are usually open as they fail to close without efforts due to increased lower third of the face. Consequently, it may stimulate undesirable mouth breathing which further worsens occlusion. Frequently malocclusion can have strong negative effect on speech function and often it can be accompanied by jaw joint pain.

           And last but not least, occlusion and the position of jaws define the height of the lower third of the face to the greatest extent, hence the aesthetics of the facial profile as well. Convex ‘bird face’ or concave ‘mature face’ profiles are considered anaesthetic, therefore severe anomalies can cause social problems if left untreated.

 *What  is the course of  Orhognathic  treatment ?

             Orthognathic treatment takes about two years to complete. It is very specific and consists of several stages, one being orthognathic surgery. Once begun, it is seldom possible to reverse the orthognathic treatment or switch to non-surgical treatment, so it is strongly recommended that the original treatment plan be completed once begun. A patient who has decided to have an orthognathic treatment should understand that this surgery is a complex and time consuming process. Therefore, only a combination of the patient's cooperation and good-will, accompanied by the doctor's support, can meet the challenge of achieving correct occlusion and facial harmony.

            The treatment plan is prepared after the initial consultation. The treatment plan is a detailed explanation of the entire treatment process for each individual patient which then, every doctor involved in the treatment will follow. It is of vital importance that the patient makes a resolute decision about having orthognathic treatment, for once started, the treatment is extremely difficult to reverse.

           At the beginning of the treatment, teeth are restored while, at the same time, useless teeth, as well as, the wisdom teeth are removed. Subsequently, once the orthodontic treatment is started it lasts for about 18 to 24 months. When the teeth are set, orthognathic surgery is performed on one or both jaws, followed then by the final orthodontic treatment which, in itself, lasts approximately 6 months.

           Once the braces are removed, if necessary, select teeth may receive restorations or crowns, or, dental implants may be inserted and restored in edentulou areas. After all this is completed, the patient will enjoy and benefit from a stunning smile and pleasing facial features.

*Attractiveness of Face.

                Every day we meet and speak to new people. What determines our perception, whether the face of a new man or a woman you have just come across is attractive or not? Probably it would be difficult to find two non-relative persons with exact faces on earth, but it is considerably easier to find people, who have similar eyes, cheeks, nose, lips, or chin. Why does one face created from the same “details” look more attractive than the other? Is facial attractiveness determined by the beauty of several separate facial parts? Or probably we can say that it is determined by the harmony rather than beauty of individual facial parts?

          Scientists have been on the way in seeking an answer to this question for years trying to find which part of the face is playing the greatest role in the attractiveness of the face, and surgeons – trying to “attack” those parts, thus hoping to make the face more attractive by changing particular features. Do we look at the eyes, at the smile, the symmetry of the face or at the combination of several features like nose, cheeks, eyebrows or eyes when assessing facial attractiveness?

            It is stated that the distance between eyes, facial width and height, mouth size, cheek position, eye colour and shape, make a fair influence for the attractiveness of the face. Features of mature face, such as protruding cheeks, rectangular jaw and large chin are associated with the attractiveness of the masculine face. In contrary, feminine face is considered to be more attractive if it is enriched with infantile features: long distance between eyes, small chin, and wide smile. Furthermore, a face is considered even more attractive if all parts are symmetric and all regions are of average size. For the face of an ideal shape, hairstyle has no great influence, but once well fitted it can make a non-ideal face look more attractive.

          A great influence on the attractiveness of the face is exerted by the crowding of teeth or spaces between them. Anterior teeth, once correctly aligned, may influence facial attractiveness more than interrelation between jaws. However, lip projection, which largely depends on the relationship of jaws, makes the greatest influence on the attractiveness of the face.