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Correction of Jaw Deformation

    Othognathic Surgery comes from Greek words 'ORTHOS' meaning straight and ' GNATHOS' meaning jaws. Now orthognathic surgery shapes up your face by straightening your teeth with orthodontics and repositioning your jaws with corrective jaw surgery.

    WHEN JAWS AND TEETH DON'T FIT

    If your jaws don't meet correctly and your teeth don't seem to fit with your jaws, you may have a bite problem that makes eating difficult. Your face may appear off balance, and you may not be happy with the way you look. Your bones and teeth may have grown that way since you were a child, or you may have injured your face. Whatever the reason, your teeth and facial bones can be reposition to create a more balanced appearance with jaws that work together well.

    IT’S TIME FOR A CHANGE

    Your orthognathic team repositions your teeth and reshapes your jaws during the orthognathic surgery process. Your orthodontist, a dentist who specializes in the straightening of teeth, uses braces to move your teeth in to correct position for bite you will have after orthognathic surgery. Your surgeon, specially trained in this type of corrective jaw surgery, reshapes your jaws and possibly other facial bones during surgery to for a better bite and a more pleasing appearance.

    THE FRAMEWORK OF YOUR FACE

    Just as bones give shape to your whole body, bones also form the 'framework' of your face. The size and position of facial bones and the teeth in them determine how well you bite and how you look. If any of these bones are shape incorrectly, problems in your jaws or appearance can result.

    A FACIAL IMBALANCE

    If your jaws and face are out of proportion, you may have problems chewing or you may be uncomfortable with your appearance. Incorrectly shaped bones are usually caused by uneven development of your jaws early in the growth years or may be caused by an injury to the face. You may have one or a combination of these facial imbalances.

    EVALUATING YOUR BITE AND JAWS

    Starting orthognathic surgery is like starting an exercise program: physical exam helps assess your health so you can find out what it will take to reach your goal.

    Your orthodontist and surgeon work together to evaluate where your teeth and bones are, and how far they should be moved. Because of the detailed, collaborative nature of this phase, your evaluation may take up to three months.

    YOUR TREATMENT PLAN

    When your orthodontist and surgeon complete their evaluations, they may prepare a treatment plan in one of several ways. They sketch your new profile on paper, trace your new profile form X ' rays on to clear plastic film, or project and adjust your profile on computer screen. Once they have discussed your treatment plan with you, take time to weigh the benefits and risks of surgery, and then make your decision. Before making your commitment, remember that braces move your teeth for the bite you will have after surgery. Changing your mind in the middle could make your bite worse.

    PREPARING YOU FOR THE CHANGE

    Getting ready for surgery is a busy time. First, you will need to visit your general dentist for cleaning, any treatment for gum disease, and other dental work. Then you will have series of appointments with your Orthognathic team. Your Orthodontist puts on and adjusts your braces, and your surgeon plans your surgery. Just preparation phase may last up to a year and a half or longer.

    Keep your “Chin Up"

    You may feel like you are wearing braces forever, but they vital to the success of your treatment. Take time to ask your surgeon any questions, you may have and the support you need from your family and friends. And, as your surgery date comes closer your surgeon may recommend “non-chew" recipes so you can experiment and stock up on foods you will need after surgery.

    BEFORE SURGERY

    You may be advised to have a physical exam before surgery to assess your general health. You may visit the hospital to donate blood in case you need a transfusion during surgery and to have lab tests done. Don't eat or drink anything after midnight the night before surgery. You may check in the day before or the day of surgery. An Anesthesiologist or nurse anesthetist will discuss your anesthesia with you and answer any questions you may have. You will receive IV (Intravenous) fluids and medication to prevent dehydration and infection and to decrease swelling and pain. Just before surgery, you will receive general anesthesia so you won't be awake during surgery.

    RISKS AND COMPLICATIONS

    As with my surgery, there are some risks and complications. You may experience some pain and swelling in your face and neck, but most of it is usually gone within a couple of weeks. Your face may feel stiff or numb for several months. During healing, there's a risk of infection and of the bones shifting position as they heal. Your surgeon will discuss these and any other risks.

    HELPING BONES HEAL

    To aid in healing, your bones are kept from moving with fixation appliances. Your surgeon may choose screws, plates, wires as a combination. A splint may also be used to temporarily secure your bite. Screws and plates are usually not removed. Wires holding your mouth closed are removed in 6-8 weeks.

    YOUR ROAD TO RECOVERY

    Your recovery begins immediately after surgery, but you may see or feel small changes for up to a year. At just you may look different because your face is swollen and your jaw has moved, but it won't be long before you see your face take its new shape. You can slowly work up to participating in your daily activities.

    HEALING IN THE HOSPITAL

    When you just wake up, you may still feel gloomy from the anesthesia, and you will notice some swelling and numbness. You will be given pain medication to ease any discomfort. If you have difficulty speaking, using paper and pencil may help. Try to get out of bed as soon as possible. Walk around to increase your circulation, reduce swelling and speed your recovery. Begin some form of oral hygiene as soon as you can, using a mouth wash, a rinse , or a child's toothbrush. Your oral surgeon will check on you after surgery, and the nursing staff will monitor you throughout your hospital stay. You may be released in one to three days.

    HEALING AT HOME

    You may be off of work or school for up to two weeks as you recover. Most of the swelling and numbness should be gone after several weeks, but you may still feel a little puffy or numb. Drink lots of fluids to prevent dehydration and help your body heal. Begin non chew diet according to your doctor's recommendations. As you are recovering, you may only notice a subtle change in your appearance. If your appearance changes dramatically, expect that your family and friends may be surprised at the difference. Take time to explain that you are the same person, and you need them to help and support you now and throughout your recovery.

    BECOMING ACTIVE AGAIN

    Depending on the type of surgery you have, you may go back to work or school in around two weeks. Although you may want to begin with half - days, you can usually become fully active again within a couple of months. Try to avoid injury to your face. Your doctors may recommend that you may progress from liquid diet to soft foods and then to regular foods within several weeks. Your surgeon may recommend a physical therapist to teach you facial exercises that improve your jaws range of motion. Expect that your friends and co-workers may be surprised about your appearance. Instead of waiting for them to say something, you want to bring it up first to avoid an uncomfortable situation.

    THE FINISHING TOUCHES

    After your braces come off, finishing touches “Fine Tune" your bite. Wearing petitioners and retainers helps to maintain the position of your teeth. Once your total treatment time is completed, you may want to consider having other dental or cosmetic procedures done.

    OTHER SURGERY

    After Orthognathic surgery, many people consider having cosmetic procedures to enhance their new look. Your surgeon can discuss these with you, such as a face- lift, or cosmetic surgery on your eyes, noses, chin , or neck. Because your jaws are recuperating for up to a year after surgery, you may experience subtle changes in your appearance during that time. You may want to delay cosmetic surgery until you have completely healed.

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DR.BIJU THOMAS
BDS., FFDRCSI.,
(Fellow of Royal College of Surgeons, Ireland)
FICOI, (Fellow of the
International Congress of Oral Implantologists). Consultant Dental and Maxillo Facial Surgeon-implantologist. Dr. Biju Thomas is a highly ...

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