What is orthognathic or orthognathodontic surgery?

The correct and ideal position of the teeth between them is naturally present only in a part of the population.

Often the teeth do not fit together correctly because there is a more or less serious malposition (the so-called dental malocclusion).

Although it should not be considered a real disease, malocclusion can create significant functional problems: since the upper and lower teeth do not touch each other correctly, chewing, pronunciation of words, the functioning of the jaw joints, breathing, can be affected to a more or less serious extent.

Furthermore, malocclusion can be associated with aesthetic problems: chin too far forward or too far back, jaw too far forward or too far back, lips that cannot close properly.

Malocclusion of teeth can be of two main types:

In the first case, the teeth can be repositioned with fixed or removable orthodontic appliances, without touching the maxillary bone or the mandible.

In the second case, however, it is necessary to reposition not only the teeth, but also the maxilla and mandible, to allow both the correct contact of the teeth and a better shape of the face from the front and in profile.

This result can only be achieved with surgery on the maxillary bones. Orthognathic surgery or orthognathodontics is the branch of maxillofacial surgery that deals with the surgical repositioning of the maxillary bones when they are in an incorrect position.

This surgery is often associated with orthodontics, performed both before and after the surgery.

In this way, the teeth can fit together ideally and the position of the facial bones is optimized with a notable aesthetic and functional improvement (chewing, digestion, breathing, speech can improve significantly).

Who needs orthognathic surgery?

All people who have incorrect chewing that depends not only on a bad position of the teeth, but also of the bones of the facial skeleton. This depends on a non-ideal and balanced growth of these bones: exaggerated or reduced growth of the mandible, the maxilla or both.

These developmental anomalies can create a series of problems with chewing, breathing, pronunciation of words, long-term health of the mouth, teeth and digestive system (if you chew badly you can get gastritis) and seriously penalize the aesthetic appearance.

Orthodontics alone can adequately correct only the position of the teeth between them but, once growth is complete, it cannot act on the misalignment of the facial bones.

Therefore, in cases of a very backward or too forward jaw, a chin that is too far forward, too far back or deviated to the side, an open bite (inability to close the teeth), a jaw that is too far back, too far forward or excessively developed in a vertical direction, inability to close the lips without effort, difficulty biting and chewing, difficulty swallowing and speaking, chronic jaw pain and headaches, the only effective solution is often orthognathic surgery, almost always in association with orthodontic treatment.

To understand if a case of dental malocclusion depends only on the teeth or also on the badly positioned facial bones, it is useful to be visited not only by the orthodontist but also by the maxillofacial surgeon. If the surgeon believes that your case requires an intervention, you will be sent to the orthodontist.

In fact, for the diagnosis and treatment of your malocclusion and to define the type of orthodontics and surgery necessary, the maxillofacial surgeon and the orthodontist will have to work in close collaboration. The orthodontist will take care of the precise alignment of the teeth so that the surgeon can make them fit together perfectly after the surgical movements of the maxilla and/or mandible.

What are the phases of orthognathic surgery treatment?

Before starting, it is a good idea to consult with your surgeon to get all the information regarding the treatment which usually includes: