Jaw Deformity Treatment
The goal of orthognathic surgery is to restore the proper anatomic and functional relationship in patients with such skeletal anomalies. At The Mount Sinai Hospital, our collaborative team of physicians, including surgeons, dentists, and orthodontists work together to form a treatment plan. The bones of the jaws can be moved or rotated in most any direction by the surgeon to allow the teeth to come together better and restore harmony to the face.
The usual treatment plan is orthodontia (braces), several months preoperatively, to better align the teeth in preparation for surgery. In this way, the teeth can be placed more solidly over bone. This may result in a temporary worsening of the occlusion in anticipation of surgery. Thus, when the surgery is done, the best possible relationship can be established so that relapse will not be as much a factor and orthodontic treatment after surgery can be kept to a minimum. Surgical intervention is followed by finishing orthodontia for several months afterwards.
The timing of surgery is usually dependent on the completion of growth. We generally see completion of growth of the upper jaw around 15 years of age and completion of growth of the lower jaw around 16 to 19 years of age. Girls tend to complete growth before boys.
- Moving the lower jaw via sagittal split osteotomy: The sagittal split ramus osteotomy is the preferred procedure for Class II malocclusions where mandibular advancement is desired. It may also be used in patients with mandibular excess where the mandible is to be retruded (The procedure has been enhanced by new instrumentation).
- Moving the upper jaw: One of more bone cuts of the maxilla is used in orthognathic surgery to move the upper jaw upward, downward, and forward.