Orthognathic Surgery: Pre-Surgical Orthodontics, Procedures, and Recovery

Corrective Jaw Surgery (Orthognathic Surgery): Comprehensive Overview

Corrects dentofacial deformities (malocclusion, asymmetry, OSA) via maxillary/mandibular osteotomies.

Phase 1: Pre-Surgical Orthodontics (12–18 months)

• Decompensate dental camouflage (e.g., procline lower incisors in Class III).
• Align arches for stable post-surgical occlusion.
• Records: models, photos, cephalometrics, CBCT, virtual surgical planning (VSP).

Phase 2: Surgical Procedures

• Le Fort I (maxilla): Downfracture; reposition 3D (advance, impact, rotate, expand). Rigid fixation (plates/screws).
• BSSO (mandible): Bilateral sagittal split osteotomy; advance/setback/rotate. Nerve (IAN) preservation critical.
• Genioplasty: Chin advancement/setback/vertical change; often combined.
• Segmental osteotomies: For transverse discrepancies.

Phase 3: Post-Op & Recovery

• Hospital 1–3 days; IMF (intermaxillary fixation) rarely used now (rigid fixation).
• Liquid → puree → soft diet × 6 weeks.
• Swelling peaks day 3–5; resolves over weeks.
• Numbness (IAN, mental nerve) common; usually recovers months.

Phase 4: Post-Surgical Orthodontics (6–12 months)

• Detailing occlusion, settling.
• Debond, retainers (fixed + removable).

Outcomes

Improved function (chewing, speech, breathing), aesthetics, stability. 90%+ satisfaction. Risks: nerve injury, relapse, non-union, infection, TMJ changes.