Although it may not appear so at first glance, individual facial structure is largely conditioned by the shape, placement and arrangement of the jaw. Unfortunately, dentofacial deformities, i.e., a number of dental and maxillofacial dental and maxillomandibular abnormalities affect 5% of the world’s population..
Dentofacial disharmonies or deformities affect the patients who suffer from them in three major blocks: functional, esthetic and psychological. The poor positioning of any maxillofacial structure can compromise breathing, swallowing, chewing, speech and also cause multiple insecurities that can be transformed into long-term psychological disorders.
For all these reasons, we tell you the following: if you are one of the 5% of the population mentioned above, your condition has a solution. In the following lines we tell you all about orthognathic surgery, including price, procedure, expected results and possible adverse effects.. Don’t miss it.
What is orthognathic surgery?
Orthognathic surgery is defined as a procedure designed to correct conditions of the jaw and face related to malocclusion problems due to skeletal disharmonies due to skeletal disharmonies, temporomandibular joint (TMJ) disorders, sleep apnea and other such functional and physiological problems.
This type of surgery is used in approximately 5% of the general population to correct the problems described above. In general, the framework of orthognathic surgery can be summarized as follows:
- Correct macroscopic discrepancies of the mandible.
- Correct skeletofacial discrepancies associated with sleep apnea (breathing stops while the patient sleeps).
- To put an end to skeletofacial discrepancies associated with TMJ: to correct problems in biting, chewing and swallowing, for example.
- Correct facial asymmetries associated with the mandible and maxilla.
- Repair facial injuries or congenital defects.
Normally, patients who decide to undergo orthognathic surgery have been previously evaluated by an orthodontist, who has ruled that the procedure necessary to fix the problem is beyond his or her expertise. Therefore, usually, individuals who put themselves in the surgeon’s hands already have an idea of what process will be most useful to them.
Types of orthognathic surgery
Orthognathic surgery can be divided into 3 main blocks, although there are many more procedures covered. We will tell you about them in the following lines.
Orthognathic surgery of the maxilla
The maxilla is a facial bone with 4 faces, edges and angles and is considered the most important bony structure of the viscerocranium. Orthognathic surgery of the maxilla, as its name suggests, is in charge of the maxilla in the correct position in order to achieve facial harmony and a recovery of its functionality.. This will bring processes such as breathing, chewing and speech back to normal.
Depending on the sources consulted, the type and invasiveness of the procedure varies, but in general the aim is to have the least invasive intervention possible and a surgical action time of about 40 minutes.
2. Mandibular orthognathic surgery
The mandible, also called the lower jaw, is an odd, flat, central, symmetrical, horseshoe-shaped bone located at the front, back and bottom of the face. The most common of all mandibular orthognathic surgery is mandibular advancement, contemplated in people who present a small and retracted mandible with respect to the upper jaw.. This clinical picture generates important facial disharmonies and makes breathing difficult in some cases (sleep apnea), which is why it requires treatment.
3. Orthognathic maxillomandibular surgery
As its name suggests, in this case repositioning of the maxilla and mandible is required.This is the way to go when a monomaxillary surgery (the two previously described) cannot solve the patient’s problem by itself. This is the way to follow when a monomaxillary surgery (the two previously described) cannot solve the patient’s problem on its own.
As you can imagine, each of the above mentioned variants will present different steps and considerations. Even so, we can put together a general procedure that describes in a brief way the passage through the operating room. Let’s get down to it.
Once the patient is diagnosed with a dentofacial deformity, the orthodontist and the surgeon will work together to achieve the desired goal: to regularize the situation both aesthetically and functionally (occlusion). The preoperative process can be slow and expensive, as the individual who is to undergo surgery usually has to wear braces for 12-18 months in order to align the teeth and prepare the jaw structures prior to surgery..
In addition, during this time multiple tests will be performed on the patient, including X-rays and 3D models of the patient’s maxillofacial structure. This is a slow recovery invasive procedure, which is why as much preparation as possible is essential.
In general, most orthognathic procedures are performed under general anesthesia and require the patient to stay in the hospital for 2-4 days. hospital stay of the patient for 2-4 days after the operation.. During surgery, the specialist makes cuts in the maxillofacial bones and repositions them in the desired location. Once this translocation has been performed, the bone will be fixed in its new position by means of bone plates, screws, rubber bands and other elements. These tiny materials will become part of the patient’s bone structure over time.
Possible complications and side effects
It should be noted that, in most cases, the procedure is performed intraorally. This avoids the appearance of facial marks and scars, but sometimes these may be necessary. Even so, the patient’s life will change drastically for at least 1-2 months after the operation on a dental, psychological and nutritional level, which is why it is necessary to be patient and assume that it is common to experience pain, difficulty eating and strange sensations due to a “new” facial structure.
After the operation it is necessary to make multiple nutritional adjustments, maintain strict oral hygiene, avoid alcohol and tobacco consumption, take medications to alleviate pain and spend a period of rest at home for 1-3 weeks before returning to normal life. The patient’s evolution will be monitored by the specialists involved at all times.
The following is a list of possible complications that may occur during the operation:
- Blood loss30% of maxillomandibular orthognathic surgeries require a blood transfusion at some point during the operation.
- InfectionA very rare complication, as the patient is given intravenous and oral antibiotics throughout recovery.
- Nerve damageSome facial nerve structures may be compromised during the operation.
- Mandibular Relapse to the position it was in before the procedure. Since there is an internal fixation of the bone, it is difficult for this to occur.
- Mandibular fracturesVery rare, experienced by less than 2% of patients undergoing the procedure.
What to expect from surgery
Correcting the alignment and location of the maxillofacial structures already described can result in several positive outcomes for the patient. can result in several positive outcomes for the patient. Among them are the following:
- A balanced appearance of the lower face.
- Improved function of the dental structures: chewing, swallowing and speech.
- Improvement of certain speech impediments.
- Improved appearance, leading to a stronger self-esteem in the patient.
Of course, the first objective of orthognathic surgery is to address the physiological problems arising from dentofacial deformity. Even so, we should not underestimate the esthetic component: facial asymmetries can cause complexes in the patient that can be associated with certain emotional disorders, which is why undergoing orthognathic surgery solely for esthetic reasons is a more than valid option.
As you may have read in these lines, orthognathic surgery is no small feat. The patient has to prepare himself for one or more years before the procedure, both physically and psychologically, as his face will be modified with no return.The patient’s face is going to be modified with no return.
In addition, the procedure may require blood transfusions, intravenous antibiotics and other ancillary treatments. The recovery time is slow and relatively expensive, so it is necessary to be patient and follow the recommendations of the professionals. Even so, once orthognathic surgery has been performed, there are usually no complications and the patient’s quality of life improves considerably. We have given you the information: now it is up to you to decide.