Preparation for orthognathic surgery begins with the realization that unequal jaw growth is the source of your problem and the subsequent decision to do something about it (See Who Is a Candidate?).
Following that, your orthodontist will take comprehensive photographs and X-rays of your teeth and jaws. These images are then fed into a computer to produce three-dimensional models that will indicate exactly how your surgery will be approached - and give you a glimpse of what you will look like following surgery.
The orthodontist will then move your teeth into a new position and fit you with braces. This pre-surgical phase of treatment can last from 6 to 18 months. And during this period, you may think that your bite is getting worse, not better. However, when your jaws are realigned, the teeth will be moved into the proper position.
If you still have your wisdom teeth, they may need to be removed prior to lower jaw surgery. Also, in the case of severe crowding, other teeth may need to be removed to make room for proper teeth movement.
Once your teeth are moved into the proper position through orthodontics, Orthognathic surgery may begin.
An oral or maxillofacial surgeon will take casts of your teeth and place them on an instrument called an articulator. The articulator simulates the position of the jaws and allows the surgeon to perform the surgical procedure on the casts prior to performing it on you. After simulating the surgery, the surgeon fabricates a thin plastic template to guide the teeth to their proper position. The template is placed over the upper teeth at the time of surgery. During surgery, the jaw is repositioned so that it fits into the template.
The amount of work this requires depends on your specific needs. For example, to correct a receding lower jaw, the jaw is cut and moved forward from behind the teeth, along with a portion of the chin. Once repositioned, both areas of the jawbone are secured in place using plates and screws that are all internal and not visible to the eye.
Bone-plating techniques have eliminated the need for the jaws to be wired together during the healing process. And complications have been greatly reduced if not eliminated.
All procedures are now performed by the oral or maxillofacial surgeon inside the mouth. No scars are created on the face.
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