Our Summary
This research paper is about a trial that was conducted to compare two methods of performing a specific type of jaw surgery (bimaxillary orthognathic surgery) using patient-specific implants. The two methods in question are the maxilla-guided approach, which focuses on the upper jaw, and the mandible-guided approach, which focuses on the lower jaw.
The trial involved 20 patients with dentoskeletal dysmorphia, a condition where the teeth and jaws are not aligned properly. The researchers used virtual surgical planning (VSP) to prepare for the surgeries and randomly assigned the patients to one of the two methods. They then compared the surgical outcomes to the initial VSP to see how accurately the plans were implemented.
The study found that both methods were able to accurately implement the VSP. The maxilla-guided approach was slightly more accurate in repositioning the upper jaw and the front part of the lower jaw, while the mandible-guided approach provided more control over the vertical dimension. Both methods were similarly effective in positioning the back part of the lower jaw.
In conclusion, while the maxilla-guided approach was more precise in some aspects, both methods were found to be equally effective for this type of surgery. No surgical complications were observed in any of the patients.
FAQs
- What is the difference between the maxilla-guided approach and the mandible-guided approach in bimaxillary orthognathic surgery?
- What was the purpose of using virtual surgical planning (VSP) in this trial?
- Was one method found to be more effective than the other in the repositioning of the upper and lower jaws during the surgery?
Doctor’s Tip
A helpful tip a doctor might tell a patient undergoing jaw surgery is to follow post-operative care instructions carefully. This may include sticking to a soft diet, avoiding strenuous activities, practicing good oral hygiene, and attending follow-up appointments as scheduled. Adhering to these instructions can help promote healing and prevent complications during the recovery process. Additionally, the doctor may recommend physical therapy or speech therapy to help with jaw function and speech after surgery.
Suitable For
Typically, patients who are recommended for jaw surgery are those with severe malocclusion, or misalignment of the teeth and jaws, that cannot be corrected with orthodontic treatment alone. This includes patients with conditions such as:
Severe overbite or underbite: When the upper or lower jaw significantly protrudes or recedes, causing difficulty with chewing, speaking, or breathing.
Facial asymmetry: When one side of the face is noticeably different in size or shape compared to the other side.
Sleep apnea: When the airway is obstructed during sleep due to the position of the jaw, causing breathing difficulties and disrupted sleep.
Temporomandibular joint (TMJ) disorders: When the joint that connects the jaw to the skull is misaligned, causing pain, clicking, or locking of the jaw.
Difficulty with speech or chewing: When the misalignment of the jaws affects the ability to speak clearly or chew food properly.
Overall, jaw surgery is recommended for patients who have significant functional or aesthetic concerns related to their dentoskeletal alignment that cannot be addressed with orthodontic treatment alone. It is important for patients to consult with a multidisciplinary team of oral and maxillofacial surgeons, orthodontists, and other specialists to determine the most appropriate treatment plan for their specific needs.
Timeline
Before the surgery, the patients likely underwent a series of consultations with their surgeon to discuss their treatment plan and expectations. They may have also undergone orthodontic treatment to align their teeth in preparation for the surgery.
During the surgery, the patient would have been under general anesthesia and the surgeon would have made incisions in the jaw to reposition the bones. Patient-specific implants would have been used to guide the repositioning of the upper and lower jaws.
After the surgery, the patient would have experienced some swelling, bruising, and discomfort, which is common after orthognathic surgery. They would have been prescribed pain medication and instructed on how to care for their incisions.
In the weeks and months following the surgery, the patient would have attended follow-up appointments with their surgeon to monitor their healing progress and make any necessary adjustments to their treatment plan. They would have also continued with orthodontic treatment to fine-tune their bite alignment.
Overall, the patient would have experienced a significant improvement in their bite alignment and facial aesthetics following the surgery, leading to improved function and confidence in their appearance.
What to Ask Your Doctor
Some questions a patient should ask their doctor about jaw surgery, specifically bimaxillary orthognathic surgery using patient-specific implants, include:
- What is the purpose of the surgery and how will it benefit me?
- What are the risks and potential complications associated with this type of surgery?
- How long is the recovery process and what can I expect in terms of pain and discomfort?
- Will I need to follow a specific diet or care routine post-surgery?
- What are the long-term results and potential changes to my facial appearance?
- How experienced are you in performing this type of surgery and what is your success rate?
- Are there alternative treatment options available for my condition?
- Will I need to wear braces before or after the surgery, and for how long?
- Will I need to undergo any additional tests or evaluations before the surgery?
- Are there any specific instructions or precautions I should follow leading up to the surgery?
Reference
Authors: Bevini M, Zavalloni G, Federico L, Centra M, Gulotta C, Mirabile FMC, Cercenelli L, Incerti Parenti S, Marcelli E, Tarsitano A, Badiali G. Journal: J Craniomaxillofac Surg. 2025 May;53(5):632-641. doi: 10.1016/j.jcms.2024.12.022. Epub 2025 Feb 10. PMID: 39933970