Surgical correction of occlusion and facial profile (single-jaw operation, without the cost of fixators)

Everyone knows about the standard methods of bite correction - braces, plates, liners. In some cases, it is not possible to correct the bite with these methods. As a result, they resort to radical surgery to correct the bite - the bite is corrected surgically, thereby lengthening or shortening the jaws and chin. Many patients may be intimidated by the need for such surgery, and this is usually due to a lack of information. The operation is designed to correct the bite, the appearance of the face, its symmetry, and create a harmonious profile. The operation is performed by an orthognathic surgeon and, less frequently, by a maxillofacial surgeon.

It should be clarified that the operations to correct the bite are carried out during the completion of the formation of the jaws. Until the age of 18, the need for surgery is decided strictly on an individual basis. Such operations are performed if there are very serious abnormalities that do not respond to other treatments.

In adulthood, these surgeries are recommended for up to 60 years. If the patient is older, the need for surgery is decided individually, taking into account comorbidities.

What is an occlusion anomaly?

A bite is called incorrect if the upper and lower jaws do not match, the dentition closes incorrectly and, as a result, the food is not rubbed enough. A smile with a bad bite doesn't necessarily look bad. The bite is more related to health and often makes itself felt after 30 years, when there may be a pain in the temporomandibular joint, exposed tooth roots, impaired breathing, disturbed increased abrasion of the teeth, etc. The aesthetic task (to make a beautiful smile) and the functional task (to make the right bite) are always solved together.

Such a structural anomaly causes a violation of the process of chewing, speech, posture, psychological disorders. And, as a rule, seriously affects a person's appearance, distorts his natural beauty.

At the first stage, orthodontic correction and preparation for surgery are performed, at the second stage, orthognathic surgery is performed by a maxillofacial surgeon. The third stage is working with an orthodontist, orthodontic methods are used to obtain the final result.

The result of such cooperation of experts - a beautifully smooth face and a correct bite !!!

Why do occlusal abnormalities and facial disharmony occur?

Improper position of the jaws and deformed (incorrect) occlusion of the teeth are formed during the period of active growth of the body up to 10-13 years. There can be many reasons. Most often - it is a congenital defect, hyperplasia, or hypoplasia - increased (or slow) growth of the bones of the facial skeleton, as a consequence, the growth or, accordingly, underdevelopment of bone tissue.

When the jaws move relative to their normal position, the soft tissues follow them. Chin, lips, cheeks, nose, cheekbones, the contour of the profile - what shapes your appearance and facial expression, is subject to change.

When is it necessary to correct the bite by surgery?

Indications for radical bite correction surgery are:

mismatch of the skeleton of the upper and lower jaws;
disorders of the facial skeleton, associated with the pathology of the temporomandibular joint;
significant diction disorders;
the presence of a history of injuries that led to deformities of the jaws;
previously ineffective orthodontic treatment.

What are the contraindications to surgery?

There are age restrictions, the operation can be performed only for adults from 18 years of age when the period of formation of the jaws is over.

Diseases of the skeletal system, disorders of bone metabolism, as well as diseases of skeletal tissues in the acute stage;
moderate and severe periodontitis;
oncological diseases, period of chemotherapy;
precancerous diseases;
severe somatic condition of the patient, the presence of chronic diseases of the internal organs at the stage of exacerbation;
endocrine diseases;
diseases of the hematopoietic system;
neurosis at the stage of decompensation.

How is surgery performed?

Bite correction surgery is not an independent procedure and requires long-term planning and joint work of an orthodontist, gnathologist, and maxillofacial surgeon. Let's divide this process into several main stages:

Stage 1 - orthodontic training

Before surgery, it is necessary to create a "foundation" - to align the dentition with orthodontic appliances. To do this, the orthodontist conducts a complete diagnosis of the bite, consisting of radiography, photos, and diagnostic models. After decoding the data and determining the tactics of treatment - fixed the optimal tool for correction - the brace system.

Before installing braces, be sure to treat tooth decay, inflammation in the oral cavity, professional hygiene.

This preparatory stage can last from 1 to 2 years.

Stage 2 - diagnosis and planning of surgery

When the orthodontist has performed preoperative preparation, an orthognathic surgeon takes over. At the planning stage, computed tomography of the head and upper neck, photographing the face in different projections, making models of dentitions. During this time, the surgeon, based on the results of a thorough examination, performs three-dimensional modeling of the face, the patient can see what he will be after the operation, can make their wishes. In addition, changes in the volume of the airways of the nose and pharynx are calculated, which also allows you to get rid of snoring during such an operation. For this purpose modern possibilities of computer programming are used. Thanks to such training, the specialist thinks through each step, including in the event of a problem situation. All this allows you to see the expected result and protect yourself from possible difficulties in treatment.

How is surgical occlusion correction performed?

Surgical correction of the bite is performed in our clinic under general anesthesia. It can take up to 4 hours in difficult cases. The operation itself includes a direct surgical stage when the bone is surgically accessed through the soft tissues to correct its position. The surgeon performs manipulations to reduce, increase the volume of bone tissue, or its displacement using a special surgical kit and elements for fixing the bone.

After surgery, a fixative bandage is applied to the face. Sutures are applied to soft tissues, the wound surface is treated.

Because the operation is performed exclusively under general anesthesia, for the patient it is painless, under constant monitoring of vital organs and systems by an anesthesiologist.

How is the postoperative period and rehabilitation?

1. Immediately after the operation, the patient is placed on a special cooling bandage to minimize swelling and inflammation.

In the first time after surgery is possible:

edema and bruising;
sore throat;
nasal congestion;
numbness;
difficulty eating;
speech disorders.

It is forbidden to chew hard, actively move the jaw, and chop.

2. The patient remains in the hospital for another 2-3 days after surgery, under medical supervision. Discomfort, soreness, unpleasant sensations, external manifestations (edema) - all take place in about one week.

3. The surgeon sets the frequency of follow-up examinations depending on the course of the first days of the postoperative period.

4. One month after orthognathic surgery, the patient continues scheduled visits to the orthodontist to complete treatment and follow-up examinations by the surgeon.

5. The final correction of the bite after surgery takes 6 to 8 months. Then the bracket system is removed and fixed retention devices are installed to fix the result.

When are the results of the operation visible?

After the orthognathic procedure, the surgeon gives the patient recommendations for the rehabilitation process. Despite the complexity of the surgery, the results are immediately apparent. They are especially noticeable after the swelling subsides. When the rehabilitation period ends, the patient experiences a significant improvement in occlusion and harmonization of facial aesthetics. The result: increased self-esteem and improved quality of life.

What is the cost of the operation?

The cost of surgery on the jaws in case of malocclusion, in the correction of traumatic abnormalities in adults, depends on the complexity of the operation and consists of many factors:

the amount of surgery;
consumables and their cost;
doctor's qualification.