Orthognathic Surgery / Osteotomy
Surgery involving surgical manipulation of the jaws to move them to a more ideal and normal position is termed Orthognathic (”ortho” means straight and “gnathos” means jaw). The surgery to move or alter the bones is called an oestetomy (”oesteo” means bone and “otomy” means surgical movement).
This is done both for functional reasons (abnormal bite, difficulty eating, jaw pain, etc.) and for cosmetic reasons. Most commonly, it is performed for correction of an overdeveloped or underdeveloped upper or lower jaw. It is commonly done on young adults but can be performed at any age depending on the indications. This surgery may only involve one bone e.g. the mandible or may involve multiple bones and requires precise planning and is not undertaken lightly. It is important for the patient to know exactly what the surgery is, why it is being undertaken and the risks and benefits.
Who Needs Orthognathic Surgery?
People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. They may have difficulty in chewing, biting or swallowing, speech problems, chronic jaw or TMJ pain, open bite, protruding jaw, breathing problems and even clefts. Jaw growth is a gradual process and, in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health, and appearance. Injury to the jaw and birth defects can also affect jaw alignment. While orthodontics alone can correct bite problems if only the teeth are involved, orthognathic surgery may be required if the jaws also need repositioning
How is it done?
There are many types of Orthognathic surgery but most of the procedures are done in a similar fashion. With the patient asleep in the operating room, a series of very carefully controlled cuts are made in the bones of the jaws to allow them to move. Once the bones are freed, they can be moved in almost any direction depending on the specific needs of the patient. The position of the bones is determined pre-operatively and special surgical splints are made and used to make sure the bony positions are correct. Once this has been done small internal screws and plates are then used to connect the bones together again and keep them in position until the bony cuts have healed and are stable.