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Surgical Orthodontics · Resources

picture Surgical Orthodontics

What is surgical orthodontics?

Sometimes, orthodontic treatment alone is not sufficient to correct serious bite problems, jaw growth abnormalities, and facial imbalances. In such cases, orthognathic surgery or surgical orthodontics may be required to reposition the jaw, thereby functionally improving the patient's ability to chew, speak, and breathe and/or esthetically improving the facial appearance. Since moving the jaws also moves the teeth, braces are always placed in conjunction with this type of jaw surgery. This helps ensure that the teeth are in their proper positions after surgery.

Who needs surgical orthodontics?

Dr. Pickard may recommend surgical orthodontic treatment for non-growing adult patients with severe malocclusions (improper bites) or with facial esthetic concerns. All growth must be completed before jaw surgery can be performed. Jaw growth is usually completed by age 16 for girls and 18 for boys. However the pre-surgical tooth movements can begin one to two years prior to these ages.

Who performs the surgery?

Orthognathic surgery is performed by an oral surgeon, usually in a hospital setting. The fee for surgical services is separate and will be assessed by the surgeon.

How does it work?

Treatment begins with braces, usually worn for six to eighteen months, with regularly scheduled appointments for adjustments. Dr. Pickard will send you to your oral surgeon for consultation, so that details and timing of the surgery can be coordinated. As the braces cause your teeth to move, you may think that your bite is getting worse rather than better. Dr. Pickard will determine when surgery should be performed. When your jaws are moved into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.

Surgery, performed in the hospital by an oral surgeon, can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented. Questions about the nature of surgery are best discussed with the surgeon.

After a period of healing (usually about 4-8 weeks), Dr. Pickard will finish with some "fine-tuning", In most cases, braces will need to be worn for another 6 to 12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.