Surgical treatment, particularly orthognathic surgery, is the gold standard for addressing moderate to severe skeletal malocclusions. Unlike orthodontics, which primarily addresses dental alignment, surgery corrects the underlying jaw structure, providing significant functional and aesthetic benefits.

Key Achievements with Surgery

1. Correction of Jaw Position and Proportions

• Class II Malocclusion (Overbite):
  • Advancement of the mandible or setback of the maxilla.
  • Achieves a balanced facial profile with better jaw proportions.
• Class III Malocclusion (Underbite):
  • Advancement of the maxilla or setback of the mandible.
  • Improves the harmony between the upper and lower jaws.
• Open Bite:
  • Corrects vertical jaw discrepancies by repositioning the maxilla or mandible.
  • Ensures that the upper and lower teeth meet properly during biting.

2. Improved Facial Aesthetics

• Restores facial symmetry in cases of jaw asymmetry.
• Enhances facial balance by correcting vertical maxillary excess (long face) or mandibular deficiency (weak chin).
• Can refine specific features like the jawline or midface to match the patient’s aesthetic goals.

3. Functional Improvements

• Chewing and Biting:
  • Aligns the teeth properly, improving occlusion and chewing efficiency.
• Speech:
  • Resolves speech issues caused by severe malocclusions (e.g., difficulty pronouncing certain sounds).
• Airway and Breathing:
  • Treats obstructive sleep apnea (OSA) by advancing the mandible or maxilla, increasing airway space.

4. Stability and Long-Term Results

• Provides permanent correction of skeletal issues, ensuring a stable foundation for aligned teeth.
• Minimizes the risk of relapse compared to non-surgical or camouflage orthodontic approaches in severe cases.

5. Comprehensive Bite and Smile Alignment

• Works in conjunction with orthodontic treatment to achieve optimal alignment of teeth and jaws.
• Resolves severe crowding, spacing, or crossbite issues by creating adequate jaw space.

6. Addressing Complex Cases

• TMJ Disorders:
  • Relieves tension or dysfunction in the temporomandibular joint caused by malocclusion.
• Facial Trauma or Congenital Conditions:
  • Corrects deformities or discrepancies resulting from trauma, cleft palate, or syndromic conditions (e.g., hemifacial microsomia).

Advanced Techniques for Surgical Success

1. Maxillomandibular Advancement (MMA):
   • Used for severe Class II, Class III, or OSA cases.
   • Repositions both the upper and lower jaws for balanced results.
2. Distraction Osteogenesis:
   • Ideal for gradual bone elongation in cases of significant jaw deficiencies.
3. Condylectomy or Genioplasty:
   • Addresses condylar hyperplasia or enhances chin aesthetics.
4. Customized Surgical Planning:
   • Advances in 3D imaging and surgical simulation ensure precise results tailored to the patient’s anatomy.

Who Benefits Most from Surgery?

• Patients with moderate to severe skeletal discrepancies that cannot be corrected with orthodontics alone.
• Those seeking both functional improvements (chewing, breathing, speaking) and aesthetic enhancements.
• Individuals with recurrent issues such as relapse after orthodontics or persistent sleep apnea symptoms.

The Takeaway

Orthognathic surgery offers life-changing results for patients with skeletal malocclusions. By correcting the jaw structure at its core, surgery achieves a harmonious balance between function, aesthetics, and long-term stability. At Clínica Birbe, we specialize in personalized surgical solutions, ensuring that every patient achieves their best smile and functionality.

Article written by the Birbe Editorial Committee