Our Summary

This research paper discusses the importance of managing patients after they have undergone orthognathic surgery, a type of surgery that corrects conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that cannot be easily treated with braces.

The authors argue that surgeons and orthodontists need to be well-versed in the best ways to care for patients after surgery, including understanding and implementing post-surgical treatment protocols. The aim after surgery is to ensure the best possible fit of the bite (occlusion) and maintain it predictably.

In some cases, aggressive orthodontic treatment might be necessary to achieve the best bite fit. While complications can arise, recognizing them early and taking corrective steps can help minimize any negative effects. The paper touches on various aspects of post-surgical care, including potential risks and complications, and discusses topics such as mandibular and maxillary osteotomies (types of jaw surgery), occlusal plane angle (the angle at which the upper and lower teeth meet), occlusal splint (a device to correct bite), open bite (a condition where the upper and lower teeth don’t touch when the mouth is closed), palatal splint (a device to widen the upper jaw), and TMJ (a disorder of the jaw joints).

FAQs

  1. What are the goals of postsurgical orthodontic management after orthognathic surgery?
  2. What are some potential complications that can occur after orthognathic surgery and how are they handled?
  3. What are some strategies and protocols used for postsurgical patient management following orthognathic surgery?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about orthognathic surgery is to follow all postoperative instructions carefully, including proper oral hygiene, diet restrictions, and medication management. It is important to attend all follow-up appointments and communicate any concerns or complications to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle and avoiding habits such as smoking can aid in the healing process and improve overall outcomes.

Suitable For

Orthognathic surgery is typically recommended for patients with severe bite misalignment, facial asymmetry, jaw deformities, and sleep apnea. These patients may have difficulties with chewing, speaking, breathing, and overall facial aesthetics. Orthognathic surgery can help improve the function and appearance of the jaws and face, leading to better quality of life for the patient. It is important for patients to have a thorough evaluation by an oral and maxillofacial surgeon and orthodontist to determine if they are good candidates for orthognathic surgery.

Timeline

Before orthognathic surgery:

  1. Consultation with a maxillofacial surgeon and orthodontist
  2. Orthodontic treatment to align teeth and prepare for surgery
  3. Pre-surgical evaluations such as x-rays, CT scans, and dental impressions
  4. Surgical planning and discussion of treatment goals with the patient
  5. Pre-operative instructions for the patient to follow, such as dietary restrictions and medication management

After orthognathic surgery:

  1. Immediate post-operative care in the hospital or surgical center
  2. Recovery period with pain management and follow-up appointments with the surgical team
  3. Gradual transition back to normal diet and activities
  4. Orthodontic adjustments to fine-tune the bite and alignment of the teeth
  5. Long-term follow-up care to monitor healing and address any issues that may arise
  6. Potential complications such as infection, swelling, or changes in sensation in the face and mouth

Overall, the timeline for a patient before and after orthognathic surgery involves careful planning, preparation, and ongoing support from the surgical and orthodontic team to ensure a successful outcome.

What to Ask Your Doctor

  1. What are the specific goals of orthognathic surgery for my individual case?
  2. What are the potential risks and complications associated with orthognathic surgery?
  3. How long is the recovery process and what can I expect in terms of pain and swelling?
  4. Will I need orthodontic treatment before and after the surgery, and for how long?
  5. What is the success rate of this surgery for patients with similar conditions to mine?
  6. What type of anesthesia will be used during the surgery and what are the potential side effects?
  7. How will my bite and facial appearance be affected by the surgery?
  8. What is the expected timeline for seeing the full results of the surgery?
  9. Will I need to follow a specific diet or oral hygiene routine after the surgery?
  10. What are the long-term implications of undergoing orthognathic surgery?

Reference

Authors: Wolford LM. Journal: Oral Maxillofac Surg Clin North Am. 2020 Feb;32(1):135-151. doi: 10.1016/j.coms.2019.09.003. Epub 2019 Nov 1. PMID: 31685347