Orthognathic means “straight jaws”. Orthognathic surgery
is surgery on the tooth bearing bone to align the teeth. Either
the lower jaw, the upper jaw or both can be operated on to bring
the teeth into alignment. There are many conditions seen by craniofacial
surgeons that benefit from jaw shifting surgery.
Orthognathic surgery is performed as a team. Prior to any intervention,
a meeting is held with the surgeon, orthodontist and patient to
decide if the teeth can be aligned by orthodontics alone or if surgery
is also required. This is critical because the orthodontist will
move the teeth in different directions depending on what is decided.
Photos, dental models and cephalometric xrays are taken as baseline
record. About one year of orthodontic treatment with braces is usually
required before the surgery and following surgery a further 6 months
of braces helps fine tune dental alignment.
Examples of cases
Case 1. Mandibular advancement >>
Case 2. Maxillary advancement >>
Case 3. Bimaxillary osteotomy >>
A BSSO (bilateral sagittal split osteotomy) has been performed and
the lower jaw brought forward 12 mm to align the teeth. This also
helps with lip competence at rest and greatly improves facial appearance.
advancement - Pre Op
- Post Op
This boy with a cleft lip and palate has a marked underbite (note
the preoperative cephalometric position of the teeth. I have performed
a Le Fort I osteotomy and advanced the maxilla 8 mm to bring the
teeth into alignment.
- PreOp Xray
This is a 3D reconstruction of a skull of
a person on whom I have performed surgery on both the upper
and lower jaws.
The maxilla was vertically long with the teeth visible at
rest and it has been “impacted” upwards.
The mandible has been advanced.
The plates holding the Le Fort I and sagittal split osteotomies
can be seen.