Surgical Ortho

Braces are often sufficient to straighten misaligned teeth. Sometimes, though, a surgical procedure is needed as well. Surgical orthodontics helps to resolve issues with biting, chewing and speaking by repositioning jawbone structure. As well as restoring oral functionality, surgical orthodontics also enhances facial appearance. Surgical orthodontic procedures are performed by our oral and maxillofacial surgeons at your Des Moines Oral Surgeons PC working in conjunction with orthodontists.

What Is Surgical Orthodontics?

Surgical orthodontics – or orthognathic surgery – is corrective jaw surgery. It can be performed after jaw growth stops, typically around ages 17 to 21 years for males and 14 to 16 for females. Surgery is the only way to modify the size or shape of jawbones after these ages. This is because by then the jaw has stopped developing.

Orthognathic surgery remedies skeletal problems in the jaw that result in misalignment in how the upper and lower teeth come together. In these cases, misalignment of the bite is caused by the position or size of the jaws themselves, rather than by the position of the teeth in the jaws.

Jaw surgery can address concerns such as:

  • Crossbite – upper teeth biting on the inside of lower teeth.
  • Underbite – when the lower teeth project beyond the upper teeth.
  • Open bite – upper and lower teeth failing to make proper contact.
  • Overbite – upper front teeth overlapping lower teeth.

Surgical orthodontics will also improve apperance of your facial profile if you have a prominent or setback upper or lower jaw. Orthognathic surgery isn’t a single event. It’s carried out in stages over a period of two to three years during braces treatment. After the surgical procedures, patients generally continue wearing fixed braces for a further six to nine months.

What Does Corrective Jaw Surgery Involve?

Jaw surgery in combination with orthodontic treatment is a collaborative process often involving orthodontists and general dentists as well as oral and maxillofacial surgeons. It’s typically considered only when less invasive treatments such as braces are determined to be insufficient. Orthognathic jaw surgery can be performed on either the lower jaw (mandible) or upper jaw (maxilla) or both jaws, depending on the extent of misalignment.

The jaws are repositioned and held in place with small screws and plates placed beneath the gum line. The jaws don’t generally need wiring together. Instead, orthodontic elastics are used while your bite settles. The surgeon usually works inside your mouth, so you won’t be left with facial scarring. In some cases, a tiny cut at the angle of the jaw may be necessary. However, this will be virtually invisible after a few weeks.

Tooth Exposure and Bracketing

Another type of surgical orthodontics is exposure and bracketing. This entails exposing an impacted tooth – one that has failed to emerge through the gum properly. This allows your orthodontist to place a bracket on the tooth to move it into its natural position.

Orthodontic Anchors

Surgical orthodontics also includes placement of orthodontic bone anchors to help braces apply the constant pressure necessary to reposition teeth. These orthodontic mini-plates are called temporary anchorage devices (TADs). They’re used when regular banding or bracketing of teeth may not be sufficient to achieve the required movement. They can also speed up treatment time.

After Orthognathic Jaw Surgery

Initial healing after orthognathic jaw surgery generally takes about six weeks. Your orthodontist will then finish aligning your teeth with braces. Complete recovery from the surgery can take up to three months, and the entire orthodontic process – surgery and braces – may take several years.

Complications after corrective jaw surgery are rare but all types of surgery carry certain risks, including infection and a bad reaction to anesthetic or medications. Numb lips are normal immediately after orthognathic surgery, and the upper lip recovers quickly. However, it may take more time before sensation is restored to the lower lip. Some patients report areas of permanent numbness but this doesn’t affect function or apperance.

Another potential adverse side effect of orthognathic jaw surgery is a nasal tone in speech. This can happen if the upper jaw has been moved forward and the soft part of the roof of the mouth no longer reaches the back of the throat. This alters the sound of your voice because air gets into the nose as you talk. Further surgery may be needed to correct the problem. In a small number of cases, plates beneath the gum may become infected and have to be removed. This risk is greater if you smoke.

Taking Care of Yourself After Orthognathic Surgery

After orthognathic surgery, your ability to open your mouth is reduced because of swelling. So, you should eat soft foods – such as yogurt, soups and smoothies – for a few weeks. You can then return to a more normal diet but avoid hard foods for a few weeks more while the jawbones continue to heal. Oral hygiene is particularly important after jaw surgery. You can resume brushing your teeth the day after surgery. Use a soft-bristled brush for at least a few weeks.

Your oral surgeon will also advise you on measures such as:

  • Tobacco avoidance.
  • Refraining from strenuous activity.
  • Pain relief medications.
  • When to return to work or school.

Benefits of Surgical Orthodontics

Surgical orthodontics provides an effective solution when braces alone can’t correct misalignment of jaws and teeth.

Benefits of orthognathic jaw surgery include:

  • Improved dental function.
  • Better sleep, breathing, and swallowing.
  • Improvement in speech.
  • Balanced appearance of the lower face.
  • Increased self-confidence.

Corrective jaw surgery can also result in shorter overall orthodontic treatment time. It makes tooth movement with braces more predictable, which allows for better management by your orthodontist.

Want to Know More About Surgical Orthodontics?

Surgical orthodontics provides a solution to help correct moderate to severe misalignment of the jaws when more conservative treatments such as braces would be insufficient. It can bring about many positive changes for adults and teens in terms of oral functionality and enhanced appearance that couldn’t otherwise be achieved. Feel free to contact us if you’d like to know more about the benefits of surgical orthodontics at Oral Surgeons, PC.