The orthognathic surgery is a surgical intervention that is responsible for correcting the dent-cranium-maxillofacial deformities.
DENTOFACIAL DEFORMITIES. ORTHOGNATHIC SURGERY
The mouth is the key to the aesthetics of the face. The position of the maxilla and jaw not only condition the form of biting, but also sets the facial structure.
These alterations are not always correctable by conventional orthodontists (move teeth), and the skeletal bases needs to be moved (move bones).
With the help of radiological and photographic studies, we will plan and reach a consensus with the patient and his orthodontist to perform those bone movements that will allow us to obtain real results in which the esthetics of the face go side by side with an optimal occlusion.
These alterations can be:
- Congenital (they are born with them) or
- Acquired (they appear after traumatisms, illnesses…)
And we can classify them in:
Mandibular prognathism (class III occlusion): It characterized by a jaw prominence or a retrusion of the upper jaw or the combination of both.
Its correction will be done by advancing the maxilla, delaying the jaw or combining both.
Mandibular Retrognathia (class II occlusion): Lack of mandibular projection. Its correction is based on advancing the mandible, accompanied sometimes by a mentoplasty (chin plastic surgery).
The conventional treatment is often unsatisfactory with conventional techniques, so bone distraction is a tool that we have incorporated for solving these cases.
Facial asymmetry: When one side of the jaw grows differently than the other side, there is a difference in height of the mandibular angles, a detour of the chin, rotation of the maxilla and deviation of the nose. We have established a protocol in which we start with mandibular distraction, we make the mandible symmetrical and then, reposition the rest of the structures by means of osteotomies.
Open bite: Inability to close the teeth at previous level. Its cause is usually the breathing alterations during childhood, that by the tongue’s interposition during childhood, it conditions the maxilla and mandible’s growth.
Gingival smile: Too much exposure of the gingiva of the upper jaw to smile, involving a long, disproportionate face.
The bone movements are performed under general anesthesia, with intraoral incisions, making controlled bone fractures that we then set with miniplates.
Many times we complement the treatment with mentoplasties, rhinoplasty, malar gain, lip gain… to complement the final result.
In those cases with a small jaw, micrognathia, it is no longer necessary to wait for the child to grow, he can be treated early by bone distraction.
The great advantage is that we avoid having the child live his teenage years with this problem, improving his self-esteem in a high degree and avoiding long orthodontics.
We carry out the IMDO system through bone distraction, something in which we are pioneers in our country and with very gratifying results.