Mohammad Kamal, DMD MD PhD FEBOMFS
Assistant Professor
Oral and Maxillofacial Surgery
Department of Surgical Sciences
Kuwait University
Correct positions for the facial bones constitute the basic foundation of a balanced face with a functional jaw relationship. Many conditions of the jaw and face are related to the structure, the craniofacial malformations, the growth, sleep apnea, the Temporomandibular Joint (TMJ) disorders, the malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that lead to imbalance in the facial jaw relationship leading to a series of esthetic and functional compromises. The ramifications of these craniofacial disharmonies are not limited to their aesthetic disfigurements, but extend far beyond to directly affect the patient’s quality of life and his functional capacity to speak, hear, swallow, chew, and breath.
Most patients with jaw discrepancies and incorrect jaw relationships can undergo a surgical procedure that enables the surgeon to properly align the jaws and teeth in a correct relationship. This requires extensive surgical and dental expertise to reach a favorable facial reconstruction and dental rehabilitation.
What is an Orthognathic Surgery (Corrective Jaw Surgery)?
Orthognathic surgery is an elective surgical corrective procedure to widen, shorten or lengthen the bones, in any dimension, in the upper or lower jaws; in order to correct the skeletal facial deformities and malalignment. The underlying abnormality may be present at birth or may become evident as a person grows and develops, or may be the result of traumatic injury. In patients with cleft lip and palate, these discrepancies are exaggerated leading to an unbalanced jaw relationship.
Corrective orthognathic surgery is a surgery done along with concurrent orthodontic treatment to improve the function and appearance of the patients with dentofacial deformities. The treatment may involve surgery to the upper jaw, the lower jaw, the chin, and/or all of these bones.
Why do We Have to do the Orthognathic Surgery?
The medically-necessary orthognathic surgery is done in the presence of a severe facial deformity and functional impairment (difficulties that substantially interfere with or limit speech, breathing, chewing and/or swallowing) or in patients with obvious malocclusion and facial deformity.
How is the Orthognathic Surgery Done?
Patients usually undergo a period of corrective orthodontic treatment to align the teeth in favorable relation; in order to undergo a surgical correction. Once the necessary orthodontic treatment is achieved, the Orthodontist refers the patient to a qualified maxillofacial surgeon to plan the surgical procedure to realign the jaws. This entails detailed surgical planning to prepare the patient for the surgery. The surgery is performed under a general anesthesia at the hospital, and the patient needs to be admitted to the ward the day before the operation and to stay at the hospital for a couple of days.
Will I Have Scars after the Orthognathic Surgery?
The orthognathic surgery procedure is usually performed within the mouth; so the only scars will be tiny white lines along your gum line.
How Will I Feel After the Orthognathic Surgery?
Immediately after the surgery, patients usually feel swollen for a period of time and the pain experienced is usually mild and controlled by taking mild pain medications. The swelling improves with time until the final results are seen few weeks after the surgery. Patients are usually able to open their mouth and must first follow a liquid diet on the first day. Starting the next day, however, some gentle elastic bands are used with the braces on the upper and lower teeth, to guide your teeth into position. For the first few days, your face will be swollen and you might have some bruising especially under your chin and sometimes on your neck due to the resolving bruising from your jaws. You should be up and about within a day or two and back to a normal routine within a month.
