ORTHOGNATIC SURGERY

 

ORTHOGNATIC SURGERY (DENTOFACIAL DEFORMITIES)

The mouth is the key of facial esthetics: the positioning in between upper and lower maxillaries, the way of the bite and the facial structure.

Looking at the face, an experienced surgeon notices how the patient  bites.  Bite disorders cannot always be corrected by orthodontics (teeth mouvements) and sometimes  the skeletal base has to be mouved.
With the help of x-rays and medical pictures, and processing the information with computer help, we can
design the osteotomies for best results in order to get  a good final bite and an improvement of facial esthetics.

Bite alterations can be  congenital or adquired (trauma, sickness…) and can be classified as follows:

Mandibular prognatism (Class III oclusion): there is a jaw prominence, maxillary hypoplasia or both. The treatment consists in moving forward the maxillary, moving backward the jaw or both.

 Mandibular hypoplasia (Class II oclusion):  there is a retroposition of the jaw. Correction is moving forward the jaw and chin. Mentoplasty . In severe cases, the procedure can also correct snooring and sleep-apnea.

Facial asimetry: alteration in hemimandibular ramus, producing displacement of the chin, rotation of the maxillary and sometimes alteration in eye leveling. Treatment is based in distraction osteogenesis during growing and conventional osteotomies after growing.

Open bite: impossibility of biting with the incisors. Breathing disorders in childhood and tongue interposition is the aetiology. Maxillary and jaw osteotomies is the elective treatment.

Gun smile:correction is the impactation of the upper maxillary.

Osteotomies are performed under general anesthesia with intraoral incisions.  Bone fragments are fixed with miniplates.  Sometimes  these treatments are completed with mentoplasty, Rhinoplasty, malar augmentation, lip augmentation in order to improve the final esthetic result.

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