Orthognathic Surgery

Orthognathic surgery involves surgeries to correct skeletal and dental defects in the facial bones.
In patients with severe jaw problems, orthodontic treatment alone is not sufficient and jaw operations, i.e. orthognathic surgery, are needed to ensure ideal dental relationships.

Orthodontic treatments are treatments applied to correct the position of the teeth.
Until certain ages, changes in jaw relationships can be made by creating orthopedic effects in orthodontic treatments.
However, in patients whose growth and development period has ended, it is very limited to change the jaw relations only with orthodontic treatment.

Patients over 18 years of age with severe jaw problems require surgical positioning of the upper or lower jaw to correct this condition.
These jaw problems may include excessive anterior/ posterior/upward positioning or misalignment of the upper or lower jaw.
Orthognathic surgery includes interventions for the positioning of teeth, jaw bones, other soft and hard tissues at the correct anatomical points, the health of chewing and jaw joint functions, and facial aesthetics.
Orthognathic surgery can help orthodontic treatment to give more successful results in the long term as well as shorten the duration of treatment.

In patients who will undergo orthognathic surgery, orthodontic tooth positions can be taken to ideal positions in the first stage.
Then, while orthodontic treatment continues, the upper and lower jaws are made suitable for each other and the face through surgery.
In some cases, the patient undergoes orthognathic surgery first.
Then the tooth positions are adjusted orthodontically.
The physician decides which method to follow by planning the patient’s treatment.

In Which Situations Can Orthognathic Surgery Be Performed?

• In cases where the problem in jaw relations cannot be treated with orthodontic treatment alone
• In order to make biting, chewing functions and jaw movements more functional
• For the long-term preservation of orthodontic treatment
• In order to provide aesthetic appearance on the face
• Correction of speech problems
• In the solution of pain caused by incorrect jaw positions
• In solving problems such as breathing and sleep apnea
• In cases where the lower jaw is incorrectly positioned (in front, behind, asymmetrically on one side)
• When one or all sides of the lower jaw are underdeveloped,
• In cases where the upper jaw is incorrectly positioned (in front, behind, asymmetrically on one side)
• Underdevelopment of the upper jaw
• Open bite, in which there is an opening in the anterior region of the lower jaw and upper jaw
• In cases where the chin tip is forward, backward, small or large,
• In cases where the cheekbones are not the ideal size
• When there are changes in the shape and structure of the jaws due to subsequent factors such as accidents, trauma, tumors
• In cases where jaw joint functions cannot be performed correctly
• In cases where problems in the teeth and skeletal structure affect facial aesthetics

Who Performs Jaw Surgeries?

Jaw surgeries can be performed by dentist-based surgeons who have specialized in maxillofacial surgery or plastic surgeons who have received special training in this field.
Your orthodontist will refer you to the relevant physician.
Orthognathic surgery and orthodontics is a combined treatment and a team work.
For this reason, acting according to the guidance of your orthodontist will help you to have a healthier process.

Orthognathic surgery operations are performed in a full-fledged hospital and under general anesthesia.
In orthognathic surgery operations, besides the importance of changes in facial aesthetics, chewing function and jaw joint relations should be considered in detail.
For this reason, it is very important to be performed by surgeons with dental knowledge.

What is Orthognathic Surgery Planning?

It is the planning made by orthodontists for wire treatment before orthognathic surgery operations.
Photographs, X-rays and model analysis of the patient are made.
For planning, the patient’s tooth measurements are taken, photographs are taken, and necessary films (panoramic, cephalometric, dental tomography, etc.) are requested.
Orthodontic treatment then begins.
Before the orthognathic surgery operation, similar records are taken from the patient again and made for surgical planning.
In this interim planning, the guide splints to be used during the orthognathic surgery operation are prepared.
It is shared with the doctor and team who will perform the surgery.

Is Only Wire Treatment Possible Without Operation?

If your orthodontist has stated that orthognathic surgery is absolutely necessary in his/her examination and analysis, the ideal treatment in terms of aesthetics and function will be to undergo orthognathic surgery with braces.

Are Orthodontics and Orthognathics Different?

Orthognathic surgery can be defined as jaw surgeries involving orthodontic planning.
In this case, orthodontic treatment should first be planned by consulting an orthodontist.
Thus, the teeth are positioned in accordance with the jaw relationships.
While orthodontic treatment continues, orthognathic jaw surgery is performed to ensure the proper position of the upper and lower jaw to each other and to the face.
In some cases, your orthodontist may plan to perform the surgery at the beginning of orthodontic treatment.
This situation where orthognathic surgery is performed at the beginning of orthodontic treatment is called the ‘surgery first’ approach.
In cases where it is appropriate to perform orthognathic surgery at the beginning of orthodontic treatment, this approach provides a number of advantages.

Isn’t it possible to be treated without surgery?

Orthodontists can diagnose patients who need orthognathic surgery as soon as they step into the clinic, without even performing an intraoral examination, only by looking at the facial profile.
In such cases, orthognathic surgery operations are absolutely necessary.
In borderline cases, orthognathic surgery is decided after the necessary analyzes.
If there is a situation that can be treated without orthognathic surgery, your orthodontist will choose this path.

Are There Scars After Jaw Surgery?

Orthognathic jaw surgeries are operations performed through the mouth.
There is no intervention on the face.
There is no surgical scar.

Are Jaw Surgeries Painful?

Necessary painkillers are given to patients after jaw surgeries.
Some pain is normal at first.
This gradually decreases within a few days.

After Jaw Surgery

After most jaw operations, the patient is normally discharged the next day.
Your doctor will check you in the morning after the orthognathic surgery operation.
As a result of this check, your doctor decides whether you will be discharged or not.
The upper and lower jaws are connected to each other with tires for about a week in order for the jaw bones to adapt to their new positions and for the bones to fuse.
During this time, the patient is given a liquid nutrition diet.
One week after the operation, the elastics are removed at the control appointment.
The mouth is opened and the patient is made to perform opening and closing exercises.
These exercises are taught to the patient.
Orthodontic treatment continues for about 4 months and then the braces are removed.
There may be a loss of sensation in the operated area for a certain period of time.
In some cases, the loss of sensation may be partially permanent.
It depends on the risks of the surgery and the reaction of the patient’s body to the operation.

What are Chin Aesthetic Operations?

Chin aesthetic surgeries are aesthetic operations performed in cases where the chin is too large or too small.
These surgeries can be performed on the upper jaw or lower jaw depending on the situation.
Chin aesthetic problems often include dental problems.
Treating these neighboring anatomical structures together is very important for long-term aesthetics and function.
The specialty that deals with teeth and jaw structures is orthodontics.
It is very important for patients with complaints of jaw aesthetics to consult an orthodontist before plastic surgery or dentistry for the healthy progress of the condition.
The orthodontist will draw the ideal road map for people who come with a complaint of jaw aesthetics and direct them to the necessary departments and doctors.

Lower Jaw (Mandible) Advancement Operation

These are operations to move the lower jaw forward in case the lower jaw is congenitally behind or its development is behind.
Apart from these, the lower jaw can be brought to the ideal aesthetic position in cases that cause facial asymmetry.
The operation method is similar in chin aesthetic interventions (lower jaw or upper jaw).
The length of the jawbone can be lengthened or shortened.
For chin aesthetic operations, the patient should be expected to reach the age of 18.

In Which Situations Are Chin Aesthetic Surgeries Performed?

When the chin tip is associated with the face, if it looks smaller or larger than normal, it causes a significant facial aesthetic problem.
In this case, chin aesthetic surgeries are applied.

What is Chin Tip Aesthetics (Genioplasty)?

Chin tip aesthetics (genioplasty) is a surgical intervention performed on the tip of the chin.
Genioplasty operations are performed to reduce or enlarge the tip of the chin.
With these surgeries that create highly aesthetic results, changes are created in the appearance of the chin tip.
The chin tip is reshaped in appropriate norms with facial aesthetics.

What is Double Chin Surgery?

Orthognathic surgeries involve both the upper and lower jaw.
During the same jaw operation, the position of both the lower jaw and the upper jaw is changed.
The jaw bones and adjacent soft tissues are brought to their anatomically ideal positions.

What is Single Jaw Surgery?

Orthognathic surgery is an operation that involves only the lower jaw or the upper jaw.

Surgical Treatment of Jaw Fractures

Fractures in the jaw bones may occur after a car accident or other trauma.
In cases of jaw fracture, it is very important to perform a detailed examination.
After the examination, the technique of the surgery to be performed is decided.

Jaw Fracture Post-Surgical Care

After jaw fracture surgery, teeth should be brushed gently with soft-tipped brushes.
Nutrition should be made with soft foods.
After jaw fracture surgery, the upper and lower jaws do not need to be connected to each other as in orthognathic surgery.
The patient is given painkillers and antibiotics.

Surgical Treatment of Cleft Lip and Palate

Cleft lip and palate are deformities involving the anatomical structures in the facial region that occur while the baby is still in the womb.
It is seen due to the merging defect of the structures in the facial region during the embryological period.
Although the exact causes of cleft lip and palate are unknown, genetic and environmental factors, certain medications used during pregnancy, folic acid and vitamin B deficiency, smoking and alcohol use during pregnancy, infectious diseases can lead to cleft lip and palate.

Cleft lip repair surgery is usually performed when the baby is 3 months old, depending on the weight of the baby.
The aim of cleft lip repair is to provide an aesthetically close to normal appearance.
In cleft palate repair, the physiological problem is corrected by restoring muscle function, and healthy progression of speech and appearance is ensured.

Treatment of Jaw Tumors

Jaw tumors can be benign or malignant tumors.
Jaw tumors occur in the mouth and jaws as a result of various irritations of the soft tissues in the mouth (smoking, etc.) or as a result of deterioration of teeth and tooth-related structures.
Treatment of jaw tumors is determined as a result of treatment planning.

Orthognathic surgery improves the aesthetic and functional quality of life of patients.
Incorrectly positioned lower jaw and upper jaw cause problems such as eating, chewing and speaking.
It can cause secondary effects on many disorders, from jaw joint disorders to problems in the digestive system.
Orthognathic surgery brings permanent and successful solutions to these problems.