Corrective Jaw Surgery
Corrective jaw surgery (Orthognathic surgery)
treats the misalignment of the jaw through surgical repositioning. Jaw surgery
may be for you if you have an abnormal bite or have a misaligned jaw. People in
need of jaw surgery often have:
- Difficulty with eating
- Speech or breathing
- Chronic jaw pain or an open bite.
During a comprehensive
examination, our surgeons will use facial x-rays to explain the best surgery
routes available to you. This consultation will help you better understand how
your bite will be improved.
This surgery moves your jaw into a new
position to improve the functionality of the relationship between your teeth and
jaws. While you will find that your smile will undergo an aesthetic improvement,
more importantly, the new positioning will improve your long term dental health.
If you live in or around Austin
and have a question about corrective
jaw surgery, call us today!
A dental implant is essentially an artificial tooth root which is attached to the jaw bone. Eventually, a replacement tooth or bridge will be firmly fixed to this root, restoring complete function to the tooth. The key to a successful and long-lasting implant is the quality and quantity of jawbone to which the implant will be attached. If bone has been lost due to injury or periodontal disease, a sinus augmentation can raise the sinus floor to allow for new bone formation.
In the most common sinus augmentation technique, a tiny incision is made near the upper premolar or molar region to expose the jawbone. A small opening is cut into the bone and the membrane lining the sinus on the other side of the opening is gently pushed upward. The underlying space is filled with bone graft material and the incision is closed. The bone which is used for this procedure may be from your own body or from a cadaver. Sometimes the dentist might use synthetic materials which can also stimulate bone formation. The implants are placed after healing has occurred; this will depend on the individual case. Sinus augmentation has been shown to increase the success of dental implant procedures.
Corrective Jaw Surgery (Orthognathic Surgery)
Orthognathic surgery refers to the surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area.
Orthognathic surgery is generally performed by an Oral and Maxillofacial Surgeon to correct malocclusion (bad bite) in cases where routine orthodontic treatment has not or will not be effective. Orthognathic surgeries include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy.
There are several classifications of malocclusion (the improper coming together of teeth) which may require orthognathic surgery:
Class I Occlusion – This malocclusion means that the lower anterior
incisors sit directly behind the upper anterior incisors when the
patient bites down. This is considered less destructive than Class
II and Class III malocclusions.
Class II Malocclusion – This is identified when the lower anterior incisors lie significantly
behind the upper anterior incisors during the biting process; in some cases hitting the soft tissue
behind the upper incisors. This is commonly referred to as an overbite and can cause discomfort,
bone damage, excessive wear of the front teeth, and tooth loss.
Class III Malocclusion – This is commonly known as an underbite and occurs when the lower anterior
incisors and lower jaw are positioned beyond the upper teeth, making the lower jaw much more
prominent than the upper jaw.
Reasons for orthognathic surgery
The malocclusion of the teeth can create greatly destructive forces among the five powerful muscles that control the
closing and opening of the jaw. These muscles generate a tremendous force when clenching, grinding or chewing.
Misalignment can seriously damage the function and aesthetic appearance of the teeth in many ways if left untreated,
Tooth Wear – In the case of an overbite, the pressure and wear on the teeth is not spread
evenly. This can also lead to TMJ, migraine headaches, and tooth loss.
Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth alters the way the
facial muscles interact. In some cases, the meniscus cartilage which acts as a buffer between the jawbones
can be painfully damaged.
Loose Teeth – When uneven pressure is continually exerted in unintended places or soft
tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain
and reduces proper function.
Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the
nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods
Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor
alignment of the upper and lower jaws.
What does orthognathic surgery involve?
When the dentist identifies a patient as a candidate for orthognathic surgery, a complete photographic analysis is initially undertaken. This includes panorex x-rays, cephalometric x-rays, models, impressions, and radiographs. Your oral & maxillofacial surgeon, your orthodontist and your dentist will work together and consider how the corrective surgery will impact both proper jaw function and the aesthetic appearance of the entire face.
Generally, orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You may also be provided with a modified diet (if required).
Facial Trauma Reconstruction
Oral & Maxillofacial Surgeons are specialist trained to manage and treat facial trauma. There are an infinite number of ways in which the face can be damaged and thus need some type of reconstruction. Accidents, falls, automobile crashes and interpersonal violence are among the most common causes. Some of the main types of facial injuries resulting from these instances are lacerations, fractured teeth, fractured jaws, fractured facial bones, knocked out teeth and intraoral lacerations.
There are three main classifications used by health professionals in their trauma assessment:
- Soft Tissue Injuries – Soft tissue trauma includes lacerations to the skin and any kind of intraoral (gum) damage.
- Avulsed (knocked out) Teeth - Injuries to the teeth are very common and must be dealt with immediately to insure success of reimplantation.
- Bony Injuries – This category encompasses the entire face including fractured cheekbones, jaw bones, eye sockets, palates and noses.
- Special Regions – Special regions refers to the nerves in the face, the eyes, and the salivary glands.
Reasons for Facial Trauma Reconstruction
Aside from the obvious aesthetic reasons for repairing damage to the face, there are also a number of serious health and dental concerns that can arise from even a small amount of trauma. No facial injury should be taken lightly. Depending on the exact location of the injury, respiration, speech and swallowing can be greatly impaired.
Though broken facial bones are generally treated in the emergency room, damage to the teeth can be quickly dealt with by the dentist. Failure to treat dental and facial trauma can lead to the following longer term problems:
- Loss of Functionality: When teeth have fallen victim to trauma, they may become loose in their sockets and make eating and speaking much more difficult.
- Smile Aesthetics: Chipped, broken or missing teeth can be detrimental to a beautiful smile. The dentist is able to repair chips, fractures and missing teeth easily.
Bite/Jaw Irregularities: After trauma, it is possible that the teeth will become badly aligned. The poor alignment of the teeth can lead to TMJ, uneven teeth wear and other complications.
What does correcting facial trauma involve?
If facial bones have been fractured or broken, they will be treated in much the same way as any other broken bone. Of course, a plaster cast cannot be applied to a cheekbone, but the bones can be held firmly together by either wiring or the insertion of small plates and screws. Soft tissue lacerations will be treated immediately by way of suture (stitching).
In cases where a tooth has been knocked cleanly out of the mouth, there is still a possibility of reinserting it. The quicker a re-insertion can be performed by the dentist, the greater the likelihood that the natural tooth will survive. In the event that the tooth lacks the ligaments necessary for reinsertion, the dentist can implant a prosthetic tooth to restore both functionality and aesthetic appearance. The dentist can also “splint” displaced teeth using structural support such as bonding or wiring with a good amount of success. Root canal therapy is also a possibility for loose or broken teeth.
Your dentist will conduct a thorough examination and take various x-rays in order to determine the precise condition of the afflicted area and plan a course of action. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery.
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