What Is Orthognathic Surgery?

Dento-maxillofacial deformity refers to abnormalities in the volume and morphology of the jawbone caused by abnormal development of the jawbone and the relationship between the upper and lower jawbone and other bones in the craniofacial region, and the accompanying jaw, tooth relationship, and oral and maxillofacial system Abnormal function and facial morphology. The purpose of orthognathic surgery is to correct misaligned teeth, adjust the uncoordinated relationship between the dental arch and the jaw, eliminate dental and jaw interference, line up the dentition, and eliminate the compensatory tilt of the teeth, so that the incision can be performed smoothly during surgery. Move to the designed correction position and establish a good relationship between teeth and jaw.

Orthognathic surgery

Dento-maxillofacial deformity refers to

As early as 1928, Fauchard tried to use a pair of forceps to correct individual tooth dislocations, but the surgical treatment of bony dental and jaw deformities was created by Hullihen in 1848 and first reported in 1849. Since then, although many scholars have made efforts to explore and improve, but limited to the level of science and technology and medicine at that time, the therapeutic effect was very unsatisfactory, so in the following 100 years,

1. The doctor discusses the surgical plan with the patient, performs the operation after the patient agrees, and performs orthodontic treatment according to the plan, eliminating the interference of the teeth, so that the incision bone segment can be smoothly moved to the designed correction position during the operation.

2. According to the specific conditions of orthognathic treatment, evaluate and guess the surgical plan, and adjust if necessary.

3. The patient performs preoperative preparations, and further analyzes the surgical plan, expected effects and possible problems.

4. The patient undergoes orthognathic surgery.

5. Regular observation is required for at least 6 months after the operation. If there is a problem, you need to go to the hospital for treatment accordingly.

After the surgical plan is determined, the position of the teeth and jaws must be corrected according to the plan.

After the end of the orthodontic treatment before the operation, the last evaluation and prediction of the original surgical plan is needed, and the necessary adjustments to the surgical plan or necessary supplements to the orthodontic treatment are made to make the upcoming surgery in line with reality and obtain best effect.

In addition to routine general anesthesia and blood transfusion preparations, the occlusal guide plate and the required fixed device after the bone mass is moved should be prepared according to the designed operation method. According to the surgical plan, predicted effects and possible problems, the patient should be prepared. Full explanation, and get the full understanding and consent of the patient.

The surgical design must be performed strictly according to the prediction and re-determined before the operation. It must not be changed arbitrarily during the operation, but it is possible and should be paid attention to the actual necessary adjustments during the operation.

Even if the surgery is successful, the apex of the upper and lower teeth will not be coordinated and the occlusion will be uneven.

Understand the possible changes of jaw and teeth relationship

Inferior alveolar nerve injury

The inferior alveolar nerve predominates the sensation of the teeth of the lower jaw and the skin near the lower lip. Since the position of the nerve in the mandible approaching is close to the incision site during the sagittal dissection of the mandible, it may be damaged by vibration and stretch during the operation, or it may be contused when the bone mass is fixed. After the injury, the skin near the lower lip becomes less sensitive, and the chance of occurrence is about one in ten. About 90% of patients will gradually improve recovery after three or four months, but a few people may recover incompletely, and the lower lip will continue to feel dull. However, it does not affect daily life, and the movement of each part of the face is not affected, and there will be no drooling.

Postoperative bleeding and hematoma

Because the periosteum within the surgical range needs to be stripped, clot swelling and swelling may occur, which is medically called hematoma. The chance of occurrence is about 20-30%. Most hematomas are mild and absorb themselves. There are only a few cases where the amount of hematoma will be large, indicating that there may be continuous bleeding at the surgical site. At this time, it is necessary to urgently go to the operating room to stop bleeding.

Postoperative infection

All surgeries have a chance of infection. Because the incisions in orthognathic surgery are mostly in the mouth, postoperative poor oral hygiene and abnormal daily life will increase the chance of infection. Overall, the chance of infection is about three percent. Most of the postoperative infection treatments only need to be tracked in the clinic and treated with antibiotics. In some cases, it may be necessary to open the wound slightly at the clinic to drain the infection and help recover. Only a few need to be hospitalized, given antibiotics or debrided.

Oral skin abrasions

Because the surgery is in the mouth, all the instruments must reach into the mouth. For the skin near the lips, especially the corners of the mouth, about 50% or more of the chances will cause some superficial skin abrasions in one to two weeks. Heals on its own, and usually leaves no scars.

Psychological Problems After Face Shape Change

After undergoing orthognathic surgery, the characteristics of the face will change significantly. Although the result of the surgery will make the face shape normal, some people will have problems with self-identification. Relatives, friends, and colleagues around you may not know you because of the difference in face shape. If they agree with the facial features before the operation and have some unintentional negative evaluation after the operation, then it will cause psychological stress and adaptation problems.