The preparation for surgery may also be called „surgery programming.“ This is an extremely thorough stage with unique tools and appliancies that are made to ensure the precision of the operation.
This preparation begins 1 to 2 weeks prior to surgery. By this time, the orthodontic treatment is finished and the braces are no longer effective in adjusting the teeth. All the preparative diagnostical analyses are done by the surgeon since the surgeon will be responsible for the precision of surgery and the postopertive result.
During the first preoperative visit two sets of teeth impressions are taken and a wax registration of the occlusion is performed. Plaster models are produced and fixed into the articulating device. The wax register is used to interrelate the models identical the teeth in the patient‘s mouth. The same wax register is used during X-Ray or CT examination of the patient. There are two critical instructions for the patient during the scanning procedure: the teeth must be in occlusion in the wax register with the lips and chin muscles totally relaxed - the lips may be seperate if this is the usual relaxed position of the lips. This is extremelly important for facial diagnosis and surgical planning. During the first preoperative visit the final facial and occlusal photographs are taken and a list of required medical tests is provided.
During the second visit the facial and occlusal measurements are re-taken. Repetitive measurements decrease the possibility of error. After this visit a precise surgery plan is prepared. The operation plan is first simulated into the software and then onto the articulated models by cutting plaster models and then putting them into the correct posisiton. Following this procedure, the models are taken back to the laboratory where custom tools are made for the surgery.
During the third visit the patient is familiarized with the precise surgery plan and the desired postoperative facial outcome. Surgical procedures, risks, individual risks, possible solutions and complications are also discussed in detail. The custom tools fabricated for this specific surgery are tried in the patient‘s mouth. During this visit, the latest lab test results are also evaluated.