Orthognathic Surgery

Orthognathic surgery refers to the surgical repositioning of the maxilla, mandible, and the dentoalveolar segments to achieve facial and occlusal balance. One or more segments of the jaw(s) can be simultaneously repositioned to treat various types of malocclusions and jaw deformities.

Preoperative

Postoperative

Following Upper Jaw Advancement

Preoperative Diagnosis

Preoperative diagnosis and planning for patients with jaw asymmetries and deformities include a photographic analysis and a complete orthognathic work-up involving cephalometric and panorex radiographs, dental impressions, and models. This is done by the Pedodontist/Orthodontist in coordination with the craniofacial surgeon. All findings are analyzed and pre-surgical model surgery performed to ascertain the feasibility of various treatment options. Additionally, computer analysis is done pre-surgically by the craniofacial surgeon to simulate surgical results, thereby facilitating proper planning of the case. Computer analysis provides the craniofacial team with visual information and numerical data that is a compilation of many time-consuming calculations such as those used in various cephalometric analyses (Steiner, Ricketts, or Jarabak- Bjork)

Preoperative

Postoperative

Preoperative Orthodontics

Usually, pre-surgical orthodontics is necessary to straighten the teeth and align the arches so that a stable occlusion can be obtained postoperatively, while orthodontics following surgery is frequently required to revise minor occlusal discrepancies. Orthognathic surgery is often delayed until after all of the permanent teeth have erupted unless medical conditions necessitate that the surgery is performed earlier. In adult patients, orthognathic surgery can be combined with soft tissue contouring to improve the aesthetic results.

Preoperative

Postoperative

Maxillary Advancement

Maxillary advancement is a type of orthognathic surgery that may be necessary to improve the facial contour and normalize dental occlusion when there is a relative deficiency of the midface region. This is done by surgically moving the maxilla with sophisticated bone mobilization techniques and fixing it securely into place. For most patients, the use of screws and mini plates have replaced wiring of the bone and teeth required to hold the jaw stable. Inlay bone grafts can be utilized for space maintenance and secured with screw and plate fixation, while onlay bone grafting is used to augment the bony skeleton and improve facial soft tissue contour.

Preoperative

Postoperative

Occlusal Discrepancy

Depending on the soft tissue profile of the face or the severity of an occlusal discrepancy, problems with the lower face may require surgery on the mandible. This can be done in conjunction with or separate from maxillary surgery. The mandible can be advanced, set back, tilted or augmented with bone grafts. A combination of these procedures may be necessary. Pre-operative planning is crucial to the success of the procedure and evaluates the surgical and orthodontic options. The surgeon chooses the type of mandibular surgery based on his experience, evaluation of the photographic and cephalometric analysis, and model surgery. Following any significant surgical movement of the mandible, fixation may be accomplished with mini-plates and screws or with a combination of interosseous wires and intermaxillary fixation (IMF). Rigid fixation (screws and plates) has the advantage of needing limited or no IMF. However, if the interosseous wiring is used, IMF is maintained for approximately six weeks. Nutritionally balanced, blenderized diets are important for proper healing in the patient in IMF.

Preoperative

Postoperative

Chin

The chin is an important component of the facial profile as well as the aesthetic balance. The position and projection of the chin should be evaluated in patients considering orthognathic and facial soft tissue contouring procedures. Photographic and cephalometric analysis help determine the amount of change necessary to obtain a well-balanced face. The chin can be augmented with such alloplastic materials as silicone, polyethylene or hydroxyapatite. However, most craniofacial surgeons prefer a sliding horizontal osteotomy genioplasty. This procedure tends to give a more natural contour to the chin and avoids the risk of extrusion that goes along with alloplastic implants.

Preoperative

Postoperative

Contact Us!

American Society of Plastic Surgeons
American Society of Maxiofacial Surgeons
American Society For Aesthetic Plastic Surgery
American Society of Craniofacial Surger
International Society of Craniofacial Surgery
American Associatin of Plastic Surgeons

Sargent Craniofacial Surgery

2290 Ogletree Ave Suite 112

  Chattanooga, Tn 37421   

                423 305-7274                         Fax- 423 206-2826           

  • Facebook Cleft and Craniofacial Utah
  • YouTube Cleft and Craniofacial Utah

Web Application by Med-10

All information provided on this website, either via email, contact forms, and/or booking is done so in compliance with the 2013 "high-tech Act" Omnibus amendment to The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II)