Orthognathic Surgery Ft. Lauderdale
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:
Orthognathic Surgery Presentation
To provide you with a better understanding of orthognathic surgery, we have provided the following multimedia presentation. Many common questions pertaining to orthognathic surgery are discussed.
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- 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 SimplantÂ® 3D treatment planning software, Dr. Sultan can virtually plan every aspect of your surgical procedure with more accuracy than conventional techniques:
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.
Deficient Lower Jaw
Excessive Lower Jaw
Excessive Upper Jaw
Combination Deficient Upper / Excessive Lower Jaw
Ready For Surgery
Deficient Lower Jaw / Open Bite
SURGICALLY ASSISTED RAPID PALATAL EXPANSION (SARPE)
SARPE may be indicated for those patients who have a narrow upper jaw that does not align properly with the lower jaw. Clinically, they present with a CROSSBITE. Many times they also have a deficiency of the upper jaw resulting in an UNDERBITE. In growing patients, the mid-portion of the upper jaw (palatal suture) is incompletely formed, and expansion can be performed non-surgically with an orthodontic appliance. However, in adult patients, this suture is fused and cannot be expanded without surgery. Depending upon the amount of expansion required, Dr. Sultan and your orthodontist will determine whether a SARPE or a multiple section MAXILLARY OSTEOTOMY is indicated. A SARPE is normally performed as a separate procedure prior to orthognathic surgery. The technique is based on the principle of DISTRACTION OSTEOGENESIS
SARPE can be performed safely in our hospital style operating room under sedation or general anesthesia. Prior to the procedure, your orthodontist will apply an expansion device to your upper teeth across the palate. Surgery involves an incision inside the upper lip. The bones of the upper jaw and palate are incompletely split. The orthodontic appliance is then activated by a special wire key in order to gently widen the upper jaw. The procedure normally takes less than one hour. One week after surgery, the upper jaw is expanded a small amount each day until the desired distance is achieved, normally within a period of 2 weeks. The bone will need to heal for 3-6 months before orthodontic tooth movement and/or additional jaw surgery can be performed.
JAW (MAXILLOMANDIBULAR) ADVANCEMENT FOR SLEEP APNEA
Sleep apnea is a disease caused by a blockage in the airway, not allowing enough oxygen arriving at the brain during sleep. Some patients with Obsttructive Sleep Apnea Syndrome have deficiencies in either the upper jaw (MAXILLA), lower jaw (MANDIBLE) or both. By advancing either one or both jaws, significant opening of the airway can be achieved. Studies have shown a high percentage of success in curing sleep apnea with this procedure. When patients have an uneven bite (MALOCCLUSION) along the jaw deficiency, treatment can be coordinated with orthodontics to correct both. Due to advanced techniques in fixating the jaws, patients do not have to have their jaws wired shut following surgery, and usually experience major relief of symptoms soon after surgery.