Surgical Orthodontics

Improper bite may result from misaligned jaws or misaligned teeth or both. Sometimes, upper and lower jaws may grow and develop at various rates resulting in necessity for jaw surgery. Even injuries and birth defects affect jaw alignment. Eating and biting can be troublesome for individuals whose jaws and teeth don’t meet accurately.A few people might be vexed on the grounds that their faces appear lopsided or unbalanced.

Orthognathic surgery is intended to correct these issues which are due to disfigurements or deformities brought on by the path in which the teeth and jaws have developed and due to disease, or injury.

Individuals who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned jaws. While orthodontics can normally correct bite or occlusion issues when just the teeth are misaligned, corrective jaw surgery helps to correct the misalignment of the jaws.

These surgical procedures are sometimes necessary to optimize the results of orthodontic treatment. They enhance one’s esthetics and functional problems as well. Surgical orthodontics is carried out as an adjunct to orthodontic treatment where treatment with only braces is not possible to get the desired result. They range from minor surgeries such as extraction to major procedures like corrective jaw surgeries of maxilla and mandible. They correct jaw discrepancies, facial discrepancies like airway defects, soft tissue defects, and facial skeletal discrepancies such astemporo mandibular joint problems.

At Apollo White Dental, our Orthodontists and Oral and Maxillofacial Surgeons work as a team to assess your dental issue and decide a treatment plan based on patient’s condition and expectations. Orthodontists will perform the braces treatment and oral surgeons will carry out the surgeries as per the treatment plan. Before the commencement of the treatment, a complete history of both medical and dental is taken and x-rays of your mouth and skull are taken. Casts or models of the teeth and jaws are normally made for comparison before and later stages of the treatment. Prior to any orthodontic treatment, our general dentist will perform cleaning of your teeth and treat any other dental issues like gum treatment, fillings etc.

MINOR SURGICAL PROCEDURES:

Minor surgical orthodontics helps to remove etiological factors and facilitate correction of malocclusion by orthodontic appliances and help prevent relapse and stabilize orthodontic results.

Extractions are the most commonly undertaken surgical procedures involving orthodontic treatment. Various extraction procedures include therapeutic extractions, serial extractions, removal of additional teeth (called as supernumerary teeth),unerupted teeth, decayed teeth and uncovering of impacted teeth.

Therapeutic extractions are done for gaining space in case of crowding of teeth. Choice of the teeth to be removed depends on the number of factors such as age of the patient, amount of space required, position of the teeth in the jaw etc. The first premolar is the most commonly removed tooth for relief of crowding. It is positioned near the center of the arch and near the site of crowding. The second reason is that the second premolar can make a similar contact with canine (sharp tooth in the front) as first premolar does. So loss of first premolar does not affect the dentition.

Serial extractions are the orthodontic procedures usually started at an early age when both baby teeth and permanent teeth are present. These are done in a planned sequence of removal of teeth to guide the future teeth into correct desired position. These are done in cases where severe crowding is anticipated. Procedures like chin increase or reduction (genioplasty) are also carried out in suitable cases in order to improve aesthetic appearance.

 

Frenectomy:

It is a surgical procedure to remove fibrous soft tissue called frenum that comes in between the upper front teeth. Frenum when over extended causes midline diastema. In such cases frencetomy has to be performed followed by orthodontic treatment.

Circumferential Supra crestalFibrotomy (Pericision)

This procedure is done as an adjunct to prevent relapse following orthodontic correction.Fibres around the tooth are cut down after orthodontic treatment to stabilize the tooth in its new position.

Major surgical procedures:

Major surgical orthodontic procedures include orthognathic surgeries and cosmetic facial surgeries. Orthognathic surgeries include osteotomies of upper and lower jaws to correct issues of jaw discrepancies.

Maxillary osteotomyis performed in severely receded or protruded jaws, severe cross bite and open bite cases.The following are the osteotomy procedures for maxillary jaw:

Lefort 1 (most widely used technique): A horse-shoe incision of the buccal mucosa and the underlying bone; this gives room to move the upper jaw upward, downward or forward.

Lefort 2 technique is used in order to achieve mid-face advancement.

Lefort 3 is performed to manage craniofacial (skull and face) anomalies.

Surgically assisted rapid maxillary expansion:

It is used in transverse maxillary (upper jaw) deficiency, posterior cross-bites, tooth-size/arch-size discrepancy, and preparation for mandibular (lower jaw) orthopedic advancement.One or more teeth and their supporting bone can be moved as a segment, either distally (backwards) to reduce increased overjet or upwards to reduce excessive upper incisor (front teeth) show up.It is a consolidated orthodontic and surgical system which encourages an expansion in transverse maxillary width both in kids and grown-ups.

Upper jaw is fitted with an exceptional key that turns a screw inside the expander to make the separation of right and left half of the upper jaw possible. The expander additionally works as a retainer after the development has happened.

Mandibular Osteotomy:

Vertical Subsigmoid Osteotomy is used to set back protruded mandible. Sagittal split Osteotomy is used to advance or push back the lower jaw to correct asymmetry.

Genioplasty:

It is a surgical procedure used to fix a receded or protruded chin. In this procedure the chin is shaped into a desired position and secured in its new position.

PROCEDURE:

The methodology used to correct your misaligned jaws will rely upon the specific condition you have. Entry points or incisions are made inside the mouth with the goal that scars should not be visible ensuring esthetics. Usually the jaw is sectioned and after that moved to the best possible proper location. New position is secured by placement of screws, plates, splints or wires. You will be given proper consideration on guiding you with when and how to clean your mouth. You will be advised to drink plenty of fluids in order to counteract dehydration and a delicate sustenance intake regimen will be prescribed. Facial activities or exercises to enhance the adaptability and flexibility of your jaw will be recommended. Changes in your appearance may not be quickly perceptible due to swelling around the zone of treatment. As the swelling goes down sensational changes are obvious depending upon the procedure.

 

Post Op

You might be wearing braces before and after the surgery for a year or more which will oblige you to visit your orthodontist consistently. The orthodontist will make certain that your teeth are moving into the right position by adjusting the braces. At the point when the teeth have acquired desired position, the braces will be evacuated; however another apparatus, a retainer or appliance may be suggested to maintain the new position and prevent relapse.