Orthognathic surgeryis surgery to correct conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that cannot be easily treated with braces. Originally coined by Harold Hargis, it is also used in treatment of congenital conditions like cleft palate. Bones can be cut and re-aligned, then held in place with either screws or plates. Orthognathic surgery can also be referred to as corrective jaw surgery.
Like any other surgery, there can be some complications such as bleeding, swelling, infection, nausea and vomiting. There could also be some numbness in the face due to nerve damage. The numbness may be either temporary, or, more rarely, permanent. In general, complications of this surgery occur infrequently.
If the surgery involved the upper jaw, then the surgery could have an effect on the shape of the patient's nose. This can be minimised by careful planning and accurate execution of the surgical plan. Sometimes, this is considered part of the benefit. Possible damage and scarring to the paranasal maxillary sinuses (located under the eyes) is a side effect to any orthognathic surgery;
Orthognathic surgery is performed by an oral and maxillofacial surgeon in collaboration with an orthodontist. It often includes braces before and after surgery, and retainers after the final removal of braces. Orthognathic surgery is often needed after reconstruction of cleft palate or other major craniofacial anomalies. Careful coordination between the surgeon and orthodontist is essential to ensure that the teeth will fit correctly after the surgery.
Planning for the surgery usually involves input from a multidisciplinary team. Involved professionals are oral and maxillofacial surgeons, orthodontists, and occasionally speech and language therapist. As the surgery usually results in a noticeable change in the patient's face a psychological assessment is occasionally required to assess patient's need for surgery and its predicted effect on the patient.
Radiographs and photographs are taken to help in the planning and there is software to predict the shape of the patient's face after surgery,which is useful both for planning and for explaining the surgery to the patient and the patient's family. Advanced software can allow the patient to see the predicted results of the surgery.
The main goals of orthognathic surgery are to achieve a correct bite, an aesthetic face and an enlarged airway. While correcting the bite is important, if the face is not considered the resulting bone changes might lead to an unaesthetic result.Orthognathic surgery is also available as a very successful treatment (90–100%) for obstructive sleep apnea.Great care needs to be taken during the planning phase to maximize airway patency.