Orthognathic surgery includes different surgical procedures which are used to correct deformities of the facial skeleton. These procedures consist of osteotomies of the jaws to reposition the latter in a better relation allowing for improved mastication and esthetics.
An osteotomy is the sectioning of bone to mobilize it. The sectioned bone is then moved to a new position and fixed using titanium plates and screws. The most common bones operated on during orthognatic surgery are the maxilla (the upper jaw), the mandible (lower jaw) and the chin.
These surgeries often require joint planning between the orthodontist and the oral and maxillofacial surgeon to coordinate the movements of the teeth and bones. In some cases, prior to surgery, a thorough clinical exam and X-rays are needed as well as a 3D computer-based planning of the surgery. The most common surgical procedures used are the Surgically Assisted Palatal Expansion (SARPE), the Lefort I osteotomy, the Bilateral Sagittal Split Osteotomy (BSSO) and the genioplasty. The SARPE procedure allows for the expansion of the palate in adult patients. The Lefort I and BSSO allow for mobilization of the upper and lower jaws to place them in the ideal relation to each other. The genioplasty moves the chin to improve lip closure and profile of the patient.
Orthognathic surgery is done in the operating room at the hospital. The patient is placed under general anesthesia. Following surgery, the patient is admitted to the hospital for a short period of time.
References :
Dr Simon Jean, résident 2 en chirurgie buccale et maxillo-faciale
