Things to Know Before Considering Orthognathic Surgery

 Orthognathic surgery, also known as jaw surgery, involves correcting the relationship between the upper and lower jaw, known as occlusion. Occlusion is crucial for effective chewing, as the upper and lower teeth need to fit together properly. A well-aligned occlusion is referred to as a normal occlusion, while an improper fit is termed malocclusion.

Malocclusion can result from two main factors: issues with the teeth themselves or misalignment of the jawbone to which the teeth are attached. When the problem is primarily related to the teeth, orthodontic treatments are used to correct malocclusion. However, in cases where there are abnormalities in the position of the jawbone, such as an underbite or facial asymmetry, orthognathic surgery is necessary to change the functional position of the jawbone and correct malocclusion.

A common misconception is that undergoing orthognathic surgery alone can fully correct malocclusion associated with jawbone misalignment. Orthognathic surgery is responsible for repositioning the jawbone functionally, but additional orthodontic treatment is crucial to ensure that the teeth align properly in the new jaw position.

It is particularly important to emphasize the significance of post-surgery orthodontic treatment, especially when pre-surgical orthodontic correction is skipped. Properly conducted pre-surgical orthodontic treatment contributes to a more stable occlusion after orthognathic surgery, reducing the likelihood of instability in jaw alignment immediately following the procedure.

〈Left〉 Pre-surgical malocclusion state 〈Right〉 Immediate post-orthognathic surgery occlusion state, where only the jaw position is aligned, and the alignment of the teeth is not optimal.

In cases where malocclusion is severe enough to necessitate orthognathic surgery due to jawbone misalignment, compensatory actions may occur between teeth that fit somewhat naturally. Surprisingly, many patients with such conditions can still perform chewing functions to a certain extent. Some patients may not even perceive discomfort, as they have never experienced teeth fitting perfectly. Pre-surgical orthodontic treatment can eliminate these compensatory actions, allowing orthodontists to address malocclusion more accurately during the pre-surgical orthodontic phase. Patients often experience a more comfortable bite following orthognathic surgery, as the occlusion aligns better. For cases where patients face more than a year of discomfort before orthognathic surgery due to pre-surgical orthodontic treatment, a solution to reduce this inconvenience is pre-surgical orthognathic surgery. Although pre-surgical orthognathic surgery significantly reduces the prolonged uncomfortable period for patients, there is an unavoidable period of immediate post-surgery discomfort where the occlusion may not align perfectly. Pre-surgical orthognathic surgery is a treatment method developed with the patient's comfort in mind, aiming to eliminate the challenging phase that occurs for over a year before surgery during pre-surgical orthodontic treatment. The overall treatment duration is also reduced by half compared to previous methods. It is crucial to understand that, despite the benefits, immediate post-surgical discomfort with occlusion misalignment is an inherent part of pre-surgical orthognathic surgery. Patients need to be well-informed and committed to follow-up care during this critical phase in which they must closely adhere to the orthodontic team's guidance.