Our Summary

This research aimed to evaluate the long-term stability of changes in teeth and lips following combined orthodontic and jaw surgery treatment. The researchers searched through medical databases and selected studies that reported on long-term stability after such treatments. Key factors they looked at included the overbite and overjet (how far the upper and lower teeth protrude), the position of the upper and lower front teeth, and the relationship of the lips to these teeth.

After reviewing over 3000 articles, they included 11 studies in their analysis, which had follow-up periods ranging from 5 to 15 years. The findings indicated that for patients with a certain type of jaw misalignment (skeletal class III), the overjet decreased over time, while it increased for another type (skeletal class II). The overbite increased in class II patients, while class III showed varied results. The position of the lower front tooth was more stable in the vertical direction than horizontally.

Changes in the relationship between the teeth and lips seemed to follow the normal aging process and did not show significant changes after a long time. However, the results varied among patients, and more research is needed to create guidelines for long-term follow-up assessments.

FAQs

  1. What is the long-term stability of changes in teeth and lips following combined orthodontic and jaw surgery treatment?
  2. How does the position of the teeth and the relationship of the lips to these teeth change over time after orthognathic surgery?
  3. What further research is needed after this study on the long-term stability of changes following orthognathic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about orthognathic surgery is to follow post-operative instructions carefully to ensure optimal healing and long-term stability of the surgical changes. This may include adhering to a soft diet, maintaining good oral hygiene, attending follow-up appointments, and wearing any prescribed orthodontic appliances or retainers as directed. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for orthognathic surgery include those with severe malocclusions (misalignment of the teeth and jaw), facial asymmetry, difficulty chewing or speaking, sleep apnea, temporomandibular joint (TMJ) disorders, and facial skeletal abnormalities. Orthognathic surgery is often recommended for patients who have completed their growth spurt, typically around age 16 for girls and age 18 for boys. It is important for patients to have a comprehensive evaluation by an orthodontist and oral surgeon to determine if orthognathic surgery is the best treatment option for their specific case.

Timeline

Before orthognathic surgery, a patient typically undergoes a thorough evaluation by an orthodontist and oral and maxillofacial surgeon to determine the best treatment plan. This may involve orthodontic treatment to align the teeth and prepare the jaws for surgery. The patient will also undergo various imaging tests, such as X-rays and CT scans, to assess the jaw structure and plan the surgical procedure.

During orthognathic surgery, the surgeon will make incisions inside the mouth to access the jaw bones. The bones will be repositioned to correct the misalignment, and may be secured in place with plates, screws, or wires. The incisions are then closed, and the patient will begin the recovery process.

After orthognathic surgery, the patient will experience swelling, bruising, and discomfort for a period of time. They will be on a liquid or soft food diet for several weeks and will need to follow post-operative care instructions to ensure proper healing. The patient will also attend follow-up appointments with their orthodontist and surgeon to monitor progress and make any necessary adjustments to the treatment plan.

Over time, the patient will gradually see improvements in their bite, facial appearance, and overall function. The long-term stability of the changes achieved through orthognathic surgery will be monitored through regular follow-up appointments and imaging tests. It is important for patients to maintain good oral hygiene and follow any recommendations from their healthcare providers to ensure the best possible outcomes.

What to Ask Your Doctor

  1. What specific changes in my teeth and jaw alignment can I expect after orthognathic surgery?
  2. How long will it take for me to see the full results of the surgery?
  3. What are the potential risks and complications associated with orthognathic surgery?
  4. Will I need to wear braces before and/or after the surgery, and for how long?
  5. How will my bite feel and function after the surgery?
  6. What is the expected recovery time, and what can I do to promote healing?
  7. How often will I need to follow up with you after the surgery for monitoring and adjustments?
  8. Are there any lifestyle changes I need to make before or after the surgery to ensure successful outcomes?
  9. What are the long-term stability expectations for the changes in my teeth and lips following the surgery?
  10. Are there any alternative treatment options to orthognathic surgery that I should consider?

Reference

Authors: Mulier D, Gaitán Romero L, Führer A, Martin C, Shujaat S, Shaheen E, Politis C, Jacobs R. Journal: Eur J Orthod. 2021 Jan 29;43(1):104-112. doi: 10.1093/ejo/cjaa022. PMID: 32901268