Orthognathic surgery (Greek “orthos” means straight and “gnathos” means jaw) is a single or double jaw surgery which is performed to reposition the jaws. During orthognathic surgery a correct jaw alignment and occlusion, as well as, facial harmony is achieved. When the jaws are moved forwards or backwards, up or down, or rotated, the facial soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the jaws are correctly positioned a harmony between the facial features is acquired which results in a beautiful profile.
Previously, both dental and skeletal malocclusions were managed with orthodontic treatment alone. Either braces were bonded to the teeth or removable orthodontic appliances were made to align the dental arches in order to achieve the best possible interdental contact, irrespective of the position of the jaws. This method is called “orthodontic camouflage” since it usually improves the chewing function but does not correct the misalignment of the jaws. In addition, frequently the facial profile worsens after this type of treatment is completed.
Nowadays, a combined of orthodontic and surgical treatment is available for patients suffering from skeletal malocclusions. In all cases, treatment begins with preoperative orthodontic setup. After the dental arches are aligned, jaw surgery is then performed so that one or both jaws are fixed in the new correct position. Orthodontic treatment continues for a long as necessary after surgery until all the teeth are brought into perfect occlusion.
Patients from ages 18 to 45 years of age are the best candidates for orthognatic surgery. Orthognathic surgery is performed after the age of 18 years when the jaws normally stop growing. Orthognathic surgery is rarely used on children under 18 years of age. Their treatment is limited to orthodontics and growth modification of the jaws; however, if orthodontic treatment is not effective, the patient and parents must give their consent before setup for orthognatic surgery is initiated. The overall medical state and dentition, rather than the age, is of primary concern when considering orthognathic surgery for the elderly. It’s possible to operate on a senior patient; however, due to their possible weaker physical condition and worse dental and periodontal status, the orthodontic setup may be complicated, if possible at all.