Correction of Bite Disorders in the Jaw (Orthognathic Surgery)

The fulfillment of optimal speech and nutritional function in humans is only possible with an upper and lower jaw harmony that enables healthy closure and bite. When the mouth is closed, the teeth in the lower jaw (Mandible) should fit into their appropriate sockets behind the teeth in the upper jaw (Maxilla) (Normal bite or closing). In case the bite goes out of normal (Malocclusion), problems arise in speech and feeding functions, but it can also cause deformations on the bilateral jaw joint that can progress over time and cause major problems. In addition, the lower jaw of the person being behind the normal (Class-II malocclusion) or being ahead (Class-III malocclusion) can seriously affect the facial appearance and cause a decrease in the self-confidence of the person.

 

The treatment of bite disorders is basically done in two ways. The first of these is the non-surgical treatment applied by orthodontists who have specialized in orthodontics on the faculty of dentistry. Mild bite disorders can be treated in this way. The second treatment option is surgery. The point that should not be forgotten here is that the patient should be prepared for surgery in the presence of an orthodontist. The orthodontic treatment applied before the surgery can take up to one year, and during this period, the patient, the orthodontist and the plastic surgeon are in constant communication. The operation to be performed on the patient is clarified at the end of orthodontic treatment; Only the upper jaw can be intervened, only the lower jaw can be intervened, or both jaws may need intervention. In addition to all these, in some cases, it may be necessary to perform an additional jaw surgery (Genioplasty) in order to achieve optimal facial proportions.

 

The surgery is performed under general anesthesia and its duration is between 2-5 hours depending on the size of the procedures to be performed. All interventions are applied through incisions made in the mouth. Most of the cases that apply to us in the clinic are candidates for "double chin" surgery, which requires both the upper and lower jaws to be cut and fixed in the correct place. In this surgery, the chin is separated from all bone connections by first entering the incision made in the mouth for the upper jaw. Then, the splint prepared by the orthodontist is attached to the jaw and the upper jaw is fixed in its correct place by means of titanium plate screws. After this, the lower jaw is reached, the lower jaw is separated from all bone connections and fixed in its correct place with the help of the final splint. At the end of the surgery, the correct bite is checked and the patient is taken to the bed. After the operation, the patients stay in the hospital for 2 or 3 nights and receive the appropriate edema-reducing treatment during this process and are discharged to go to the orthodontist, with their teeth in the appropriate position, their jaws tied together with elastic bands.

 

After discharge, controls by the plastic surgeon and orthodontist begin, as before the surgery. During the healing period, the orthodontist follows the patient in terms of some modifications that will ensure optimal healing, especially keeping the upper and lower jaws connected to each other. The plastic surgeon, on the other hand, carries out surgical follow-ups such as the healing of the suture lines and the condition of the edema on the face. In general, the patient can return to his routine life in the 3rd week after the surgery, in the 3rd-6th week. The final result can be observed with the complete disappearance of facial edema between months.

 

Orthognathic surgery is one of the most difficult operations of plastic surgery, but it is also one of the most promising operations. In addition to the magnitude of the surgery, complications that may cause the need for additional surgical interventions can be encountered after the surgery. The preparation period, which can take up to a year before the surgery, and the recovery period, which lasts for about a month after the surgery, should be taken into consideration, and the patient should talk to his doctor in detail and decide clearly whether he really wants to go on this path. Although the way to go is quite arduous, the aesthetic and functional result obtained after a successful surgery is extremely satisfactory.