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Orthognathic Surgery


Orthognathic Surgery
What is Orthognathic Surgery?
Orthognathic surgery is a surgery performed on the bones of the jaws to change their positions. Orthognathic surgery is corrective facial surgery where deformities of the jaw exist. It may be indicated for functional, cosmetic, or health reasons. It is a surgery commonly done on the jaws in conjunction with orthodontic treatment, which straightens the teeth.
When is an Orthognathic Surgery required?
People with large jaws, or chins, or small jaws or chins, teeth which don't fit together, eyeballs which appear bulging, and flat cheekbones are examples of facial characteristics that may be improved by orthognathic surgery.
The surgery might involve one jaw or the two jaws during the same procedure. The modification is done by making cuts in the bones of the mandible and / or maxilla and repositioning the cut pieces in the desired alignment.
Incisions are made inside the mouth during surgery and there will be no visible external scars. However if external incision has to be made, as in surgeries of the tempromandibular joint , care is taken to conceal it in the natural skin creases or folds. Meticulous suturing technique can reduce the scar formation. Sometimes, it becomes necessary to remove some of the teeth during surgery to create space to reposition the jaw(s).
Some of the common surgical procedures in Orthognathic are
1. Lefort I Osteotomy: This is the surgical procedure done on the maxilla (upper jaw) to shorten or lengthen the maxilla to correct      maxillary protrusion or retrution respectively. It is also done to correct the vertical excess of maxilla (gummy smile).
2. Anterior Maxillary Osteotomy: This is used to correct the protrusion of the maxilla when there is no vertical excess of maxilla        or gummy smile
3. Saggital Split Osteotomy: In this procedure the jaw is repositioned and the jawbones are held together with the help of screws      and bone plates or by wires. The incision is closed with absorbable sutures. If wires are used to hold the bones in position            then the jaws maybe immobilized through inter-maxillary fixation for 3 weeks to allow proper healing of the bone.
4. Genioplasty: This is used to correct the defects of the chin. The chin can be augmented (increased) if it is deficient. This gives      a marked change to the facial appearance. It can even be done under local anesthesia.
5. Rhinoplasty: This is used to correct the deformities of the nose. It can be done along with orthognathic surgery or separately.        In cleft lip and palate cases nasal deformity is common. This can be corrected to a very great extend by rhinoplasty.


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