Our Summary

This research paper discusses a new method for preparing for a complex jaw surgery that traditionally required patients to wear conventional braces beforehand. Many patients, particularly older teenagers and adults who had braces in their youth, are not keen to wear these appliances again. Therefore, a less noticeable and more aesthetically pleasing option, clear aligners (like Invisalign), is gaining popularity. These aligners are typically used for minor dental issues like crowding and small rotations without significant vertical or crosswise problems. However, using these clear aligners together with jaw surgery for serious dental issues is a new and not yet common practice. The most complex type of jaw surgery, segmental double-jaw surgery, has never been reported to be performed using Invisalign. There are several potential challenges to doing so, such as the lack of bonded or banded appliances, and no archwire. This article aims to explore the possibility of performing segmental double-jaw surgery using only Invisalign, and presents a series of cases and the technical steps involved.

FAQs

  1. Can clear aligners like Invisalign be used to prepare for complex jaw surgery?
  2. What are the potential challenges of using Invisalign for segmental double-jaw surgery?
  3. Has segmental double-jaw surgery ever been performed using only Invisalign?

Doctor’s Tip

One helpful tip a doctor might tell a patient about jaw surgery is to follow all pre-operative instructions provided by the surgical team. This may include stopping certain medications, avoiding eating or drinking before surgery, and attending all necessary pre-surgical appointments. By following these instructions, the patient can help ensure a successful surgery and smooth recovery process.

Suitable For

Patients who are typically recommended jaw surgery are those with severe malocclusions, facial asymmetry, temporomandibular joint disorders, sleep apnea, and other craniofacial abnormalities. These patients may have difficulty chewing, speaking, breathing, or experiencing pain due to their jaw misalignment. Jaw surgery, also known as orthognathic surgery, is recommended when more conservative treatment options like braces, orthodontic appliances, and orthodontic headgear are not sufficient to correct the underlying skeletal issues. Patients who are not satisfied with the aesthetic appearance of their face due to a protruding or receding jaw may also be recommended for jaw surgery. Additionally, patients with obstructive sleep apnea may benefit from jaw surgery to improve their breathing during sleep.

Timeline

Before jaw surgery:

  1. Consultation with an oral and maxillofacial surgeon to discuss treatment options and determine if jaw surgery is necessary.
  2. Pre-surgical orthodontic treatment with clear aligners to prepare the teeth for surgery.
  3. Pre-surgical testing and evaluations to assess the patient’s overall health and suitability for surgery.
  4. Planning and coordination between the orthodontist and surgeon to ensure proper alignment of the teeth and jaws.
  5. Surgical preparation, including fasting before the procedure and following any pre-operative instructions provided by the surgical team.

After jaw surgery:

  1. Recovery period, which may include swelling, pain, and discomfort for a few weeks following the surgery.
  2. Post-operative care, including follow-up appointments with the surgical team to monitor healing and progress.
  3. Continuing orthodontic treatment to further align the teeth and jaws post-surgery.
  4. Gradual return to normal activities and diet as advised by the surgical team.
  5. Long-term follow-up care to monitor the results of the surgery and ensure proper alignment of the jaws and teeth.

What to Ask Your Doctor

  1. What are the benefits of using clear aligners like Invisalign for jaw surgery compared to traditional braces?

  2. Are there any limitations or risks associated with using clear aligners for jaw surgery?

  3. How will the clear aligners be used in conjunction with the jaw surgery procedure?

  4. What are the expected outcomes and timeline for using clear aligners for jaw surgery?

  5. How will the clear aligners affect the recovery process after jaw surgery?

  6. Are there any specific guidelines or instructions for wearing clear aligners before and after jaw surgery?

  7. How will the progress of the jaw surgery be monitored while using clear aligners?

  8. What alternative treatment options are available if clear aligners are not suitable for the jaw surgery procedure?

  9. Are there any additional costs associated with using clear aligners for jaw surgery?

  10. Are there any specific post-operative care instructions for patients using clear aligners after jaw surgery?

Reference

Authors: Kankam HKN, Gupta H, Sawh-Martinez R, Steinbacher DM. Journal: Plast Reconstr Surg. 2018 Jul;142(1):181-184. doi: 10.1097/PRS.0000000000004491. PMID: 29952900