Contents:
What are the steps in Orthognathic Surgery?
Evaluation:
After the initial examination a through examination with facial measurements,
photographs, x-rays, and dental impressions are made. A complete medical
examination is done to rule out any health problems that would interfere
with the surgery or the administration of General Anesthesia.
Pre-surgical Orthodontia:
The Oral & Maxillofacial Surgeon and the Orthodontist will work closely
together during your treatment. Orthodontic treatment (braces) is started
before surgery. The teeth are moved and repositioned into proper alignment
before surgery if necessary.
Preparing for the Surgery:
Orthognathic Surgery is done in a hospital under general anesthesia. Usually
you have to get admitted to the hospital one day prior to the surgery.
You have to stay in the hospital for a week or so till you have recovered
from the surgery. You have to undergo a full medical checkup. You may need
blood transfusion during the surgery. You should maintain a good oral hygiene
before and after surgery.
Surgical Procedures:
Orthognathic Surgery lasts anywhere from 1½ hours to several hours
depending on the type of surgery needed.
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 temporomandibular joint , care is taken to conceal
it in the natural skin creases or folds. Meticulous suturing technique
can reduce the scar formation.
Sometimes it maybe necessary to remove some of your teeth during
surgery to create space to reposition the jaw's.
Common Surgical Procedures are
What are the Post-Surgical care to be taken?
Immediately after surgery you will be shifted to the recovery room until the general anesthesia has
worn off. You may be kept in the ICU (intensive care unit) for 24 hours
to monitor your vital signs. You family would be allowed to see you for
a short period of time. An Intravenous (IV) line to your arm will be used
to provide the required medications and nutrients, until you are able to
take sufficient food by mouth. Elastic bandages may be placed over your
face to reduce the swelling. Minor bleeding maybe seen after the surgery.
If surgery of the maxilla has been done then there will be oozing of blood
from the nose, which will stop within 24 hours.
You can expect temporary swelling of the lips, cheek and nose. This
is a normal healing response and will disappear after a week or so. You
will experience nasal congestion and sore throat due to nasal tubes used
for general anesthesia. You may also have vomiting or nauseating sensation
due to the medications used. After been shifted to the room you will be
on a soft diet, as you won't be able to chew properly. In some cases the
jaws maybe immobilized with wires and so you will be able to take only
a liquid diet.
Oral Hygiene has to be maintained meticulously.
You have to brush your teeth properly. If you have difficulty in using an adult tooth brush
initially you may use a baby toothbrush. You have to brush you teeth and
wash your mouth with an mouthwash after every intake of food. Poor oral
hygiene will result in infection, a bad taste to the mouth and increased
swelling of the face.
You will have to stay at the hospital for a week or more, till you have recovered from your surgery.
After going back home you can return to work or school as soon as you feel
like it. It is preferred to take rest for 2-3 weeks. Your appearance will
have changed due to the repositioning of the jaws and so you should be
prepared for signs of surprise from your family and friends. But it won't
take long for them to adjust to the "new" you.
The initial healing will take 6 weeks but the completion of healing
process will take up to 9-12 months. During this period you have to visit
your surgeon and orthodontist regularly. Throughout this period oral hygiene
has to be minted strictly. In most cases the braces are removed after 6-8
months following surgery.
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updated Aug2002.