How Is Orthognathic Surgery Performed?

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Dr Vaibhav Shah

                              How Is Orthognathic Surgery Performed?

              Preparation for orthognathic surgery nearly always involves a preliminary period of between nine and fourteen months of orthodontic treatment (braces), and it should be emphasized that the orthodontist is an integral component to the success of treatment. Orthodontic appliances are not removed prior to surgery and, in fact, serve as an aid to the surgeon during the surgical procedure. Moreover, there is usually a post-surgical period of orthodontics that can vary from one patient to the next. Today, orthognathic surgery is a procedure commonly performed as a hospital based operation. The patient is often admitted on the day of surgery by his doctor and more often than not can expect to be discharged on the first post-operative day. Through the miracles offered by modern technology, the procedures most frequently utilized today are accomplished by operating completely within the mouth. At one time it was commonplace to have one’s teeth wired shut for nearly seven weeks. If you were to speak with the patient of the 70′s and 80′s they would site having their teeth wired shut as the greatest discomfort to the surgery that they were asked to undergo. Today, having your teeth wired shut is hardly ever necessary and the patient can most often resume jaw movement such as speaking, yawning and coughing almost immediately. The only limitations of jaw function still asked of nearly all patients, is to soften their diet for a period long enough following the surgery that it will allow for a stress free period of bony healing (usually four to six weeks of a mashed potato or scrambled egg consistency diet).

            It is often said by patients who are preparing for future orthognathic surgery that they are going to “have their jaw broken.” As doctors, we do not like to use the term “breaking the jaw,” because it conjures up a misconception in the eyes of the patient of a brutal and savage surgery that is haphazard and lacks control. We might more appropriately describe the procedure as a “realignment of your jaw.” This terminology more accurately expresses the methodology and precise nature of the proposed treatment. The “orthognathic treatment” begins literally on the drawing board. All surgeries are meticulously planned through the use of skeletal analyses, sketches, mock up surgeries on plaster models and even computer imaging. From this pre-operative work-up, the operating doctor can fabricate precise templates that are utilized during surgery to position the jaws. By the time your doctor goes to the operating room your proposed surgery is a carefully thought out and pre-planned event requiring only his routine surgical skills to complete the task. With the use of highly technical instrumentation along with tried and true surgical techniques the jaws are then precisely repositioned and stabilized using tiny screws, plates and/or wires. These screws and plates are only temporarily necessary after which the jaw mends itself into its new position. Because of their long standing history of biocompatibility, it is hardly ever necessary to remove them at a later date.-  Dr.Vaibhav Shah