Orthognathic Surgery

Orthognathic means “straight” jaws. Orthognathic  surgery is a procedure done to correct tooth position as well as correct jaw alignment. The goals of orthognathic surgery are to help correct problems associated with chewing, speech and breathing, will improving patients’ appearance by balancing the jaw structures.

The following is a list of possible reasons a patient may elect to undergo orthognathic surgery:

• Problems chewing
• Problems swallowing
• Speech difficulty
• Chronic jaw pain
• Excessive tooth wear
• Teeth do not come together properly
• Unbalanced facial appearance
• Excessive or receding jaws
• Inability to bring the lips together chronic mouth breathing
• Sleep apnea

Although many bite related problems can be corrected by orthodontics alone, it is estimated that 10% of this population may benefit from orthognathic surgery. A team approach, including your surgeon, orthodontist, as well as your dentist will get together and plan your care.

It is important that Dr. Sultan and your orthodontist work together closely throughout you treatment. It is advantageous to have both an orthodontic and surgical consultation before orthodontics is begun. As total treatment time may take approximately 2 years, proper planning is important to achieve the optimal result in an efficient time period.

At the initial treatment planning phase, a detailed discussion will take place regarding the sequencing of treatment, any additional dental care, and other adjunctive procedures.

Utilizing our Simplant® 3D treatment planning software, Dr. Sultan can virtually plan every aspect of your surgical procedure with more accuracy than conventional techniques:

Pre-Surgical Orthodontics

During this period, your teeth will be aligned with respect to each individual jaw. This is termed “decompensation”. In fact, it may seem that your bite will look worse, rather than better, during this period. Many times, this is actually the case. This type of tooth movement actually allows the surgical procedure to have a more predictable, stable result. Also, during this phase, you may undergo removal of impacted wisdom teeth, temporary restorative dental work. This period may last 8-18 months.

The Surgical Procedure

Your surgery may involve repositioning of the upper jaw, lower jaw, the chin, or a combination of the above. Each individual jaw may need to be sectioned in more than one component in order for the teeth to line up properly. The entire surgical procedure is meticulously planned to ensure accurate, exact (to within a millimeter!) by Dr. Sultan prior to the actual surgery by the use of x-rays, models, photographs, and specially designed acrylic wafers to line up the jaws properly during surgery. Most procedures are done in the hospital, either as an outpatient or with an overnight stay.

Postoperative Care and Orthodontics

The majority of patients return to daily activities with limitation after 1-2 weeks. Due to modern advances in bone healing, the use of plates and screws to secure the repositioned bones allow most patients to avoid having their jaws wired shut. Orthodontics is usually completed in approximately 6 months after surgical healing. Final restorative and periodontal care can then be done. If additional cosmetic procedures are desired (e.g. rhinoplasty) it is done at this time. It is important to maintain a regular maintenance schedule of visits yearly with both Dr. Sultan and your orthodontist.

Before Surgery	After Surgery	Before Surgery	After Surgery
Deficient Lower Jaw		Excessive Lower Jaw

Before Surgery	After Surgery	Before Surgery	After Surgery
Excessive Upper Jaw		Now-Aligned Jaw

Combination Deficient Upper / Excessive Lower Jaw
	Beginning Orthodontics Ready For Surgery After Surgery
Before Surgery
After Surgery

Deficient Lower Jaw / Open Bite
Before Surgery	After Surgery
Before Surgery	After Surgery