Our Summary

The article discusses two cases of sisters with a specific kind of dental misalignment, known as distal deep bite, which causes changes in the bone structure and soft tissues of the face. In the first case, a traditional three-step treatment was used involving braces to prepare the teeth, followed by surgery on both jaws and a procedure to reshape the chin (genioplasty). In the second case, the doctors chose to reshape the face using implants. The article compares the two different treatments and their results, discussing the pros and cons of each approach. It also outlines when each treatment method should be used.

FAQs

  1. What is distal deep bite and how does it affect the face structure?
  2. What are the steps involved in the traditional treatment for distal deep bite?
  3. When is the use of implants recommended over the traditional treatment method in reshaping the face due to distal deep bite?

Doctor’s Tip

One helpful tip a doctor might tell a patient about orthognathic surgery is to follow post-operative care instructions carefully to ensure proper healing and optimal results. This may include maintaining a soft diet, practicing good oral hygiene, attending follow-up appointments, and avoiding activities that could disrupt the healing process. It is important to communicate any concerns or complications to your healthcare provider promptly to address them effectively. Additionally, physical therapy or speech therapy may be recommended to help with recovery and optimize functional outcomes.

Suitable For

Patients who are typically recommended orthognathic surgery include those with severe misalignment of the jaws, facial asymmetry, difficulty chewing or speaking, sleep apnea, and issues with the temporomandibular joint (TMJ). Orthognathic surgery is often recommended for patients who have completed their growth spurt, typically in their late teens or early twenties. Additionally, patients who have tried other non-surgical treatments such as braces or orthodontics without success may also be candidates for orthognathic surgery.

Timeline

Before orthognathic surgery:

  1. Patient notices dental misalignment and consults with an orthodontist.
  2. Orthodontist assesses the misalignment and recommends orthognathic surgery as a treatment option.
  3. Patient undergoes orthodontic treatment to prepare the teeth for surgery, which may involve wearing braces for a period of time.

After orthognathic surgery:

  1. Patient undergoes surgery on both jaws to correct the misalignment.
  2. Patient may also undergo additional procedures, such as genioplasty to reshape the chin.
  3. Patient experiences swelling, discomfort, and difficulty eating in the immediate post-operative period.
  4. Patient follows a strict post-operative care plan, including a liquid or soft diet, pain management, and follow-up appointments with the surgical team.
  5. Over time, swelling subsides, and the patient gradually resumes normal eating and oral hygiene habits.
  6. Patient continues with orthodontic treatment to fine-tune the alignment of the teeth and bite.
  7. Patient experiences improved facial aesthetics, better function of the jaw, and overall satisfaction with the results of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with orthognathic surgery?
  2. How long is the recovery process and what can I expect during this time?
  3. Will I need to wear braces before and/or after the surgery? If so, for how long?
  4. What are the expected outcomes of the surgery in terms of facial appearance and bite alignment?
  5. Will I need additional procedures, such as genioplasty or implants, in conjunction with the orthognathic surgery?
  6. How experienced are you in performing orthognathic surgery and what is your success rate?
  7. Are there any alternative treatment options to orthognathic surgery that I should consider?
  8. How much will the surgery cost and will my insurance cover any of the expenses?
  9. What are the long-term effects of orthognathic surgery on my oral health and overall well-being?
  10. How soon can I resume my normal activities, such as eating and exercising, after the surgery?

Reference

Authors: Andreischev AR, Chebotarev SY, Gorban VV, Rudoman SO. Journal: Stomatologiia (Mosk). 2020;99(5):103-110. doi: 10.17116/stomat202099051103. PMID: 33034186