Global InformationOrthognathic surgery information
| Orthognathic surgery | |
|---|---|
 Osteotomies of the jaws:
1. LeFort I 2. Bilateral Sagittal Split 3. Genioplasty 4. IMDO 5. GenioPaully 6. Custom PEEK 7. SARME 8. Custom BIMAX 9. Super BIMAX | |
| ICD-9-CM | 76.6 |
Orthognathic surgery (/ˌɔːrθəɡˈnæθɪk/), also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics [1] and self-esteem.
The origins of orthognathic surgery belong in oral surgery, and the basic operations related to the surgical removal of impacted or displaced teeth – especially where indicated by orthodontics to enhance dental treatments of malocclusion and dental crowding. One of the first published cases of orthognathic surgery was the one from Dr. Simon P. Hullihen in 1849.
Originally coined by Harold Hargis, it was more widely popularised first in Germany and then most famously by Hugo Obwegeser who developed the bilateral sagittal split osteotomy (BSSO). This surgery is also used to treat congenital conditions such as cleft palate.[2] Typically surgery is performed via the mouth, where jaw bone is cut, moved, modified, and realigned to correct malocclusion or dentofacial deformity. The word "osteotomy" means the division of bone by means of a surgical cut.
The "jaw osteotomy", either to the upper jaw or lower jaw (and usually both) allows (typically) an oral and maxillofacial surgeon to surgically align an arch of teeth, or the segment of a dental arch with its associated jawbone, relative to other segments of the dental arches. Working with orthodontists, the coordination of dental arches has primarily been directed to create a working occlusion. As such, orthognathic surgery is seen a secondary procedure supporting a more fundamental orthodontic objective.
It is only recently, and especially with the evolution of oral and maxillofacial surgery in establishing itself as a primary medical specialty – as opposed to its long term status as a dental speciality – that orthognathic surgery has increasingly emerged as a primary treatment for obstructive sleep apnoea, as well as for primary facial proportionality or symmetry correction.
The primary use of surgery to correct jaw disproportion or malocclusion is rare in most countries due to private health insurance and public hospital funding and health access issues. A small number of mostly heavily socialist funded countries report that jaw correction procedures occur in some form or other in about 5% of a general population, but this figure would be at the extreme end of service [3][4][5] presenting with dentofacial deformities like maxillary prognathisms, mandibular prognathisms, open bites, difficulty chewing, difficulty swallowing, temporomandibular joint dysfunction pains, excessive wear of the teeth, and receding chins.
Increasingly, as people are more able to self-fund surgery, 3D facial diagnostic and design systems have emerged, as well as new operations that enable for a broad range of jaw correction procedures that have become readily accessible; in particularly in private maxillofacial surgical practice. These procedures include IMDO, SARME, GenioPaully, custom BIMAX, and custom PEEK procedures. These procedures are replacing the traditional role of certain orthognathic surgery operations that have for decades served wholly and primarily orthodontic or dental purposes.[6] Another development in the field is the new index called the index of orthognathic functional treatment need (IOFTN) that detects patients with the greatest need for orthognathic surgery as a part of their comprehensive treatment.[7] IOFTN has been validated internationally and detected over 90% of patients with greatest need for orthognathic surgery.[8]
- ^ Aesthetic orthognathic surgery and rhinoplasty. Derek M. Steinbacher. Hoboken, NJ. 2019. ISBN 978-1-119-18711-0. OCLC 1057242839.
{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link) - ^ Bill J, Proff P, Bayerlein T, Blens T, Gedrange T, Reuther J (September 2006). "Orthognathic surgery in cleft patients". J Craniomaxillofac Surg. 34 (Suppl 2): 77–81. doi:10.1016/S1010-5182(06)60017-6. PMID 17071397.
- ^ Posnick, Jeffrey C. (September 2013). Orthognatic Surgery: Principles and Practice. Amsterdam: Elsevier. pp. 61–68. doi:10.1016/B978-1-4557-2698-1.00003-4. ISBN 978-145572698-1.
- ^ Harrington C, Gallagher JR, Borzabadi-Farahani A (April 2015). "A retrospective analysis of dentofacial deformities and orthognathic surgeries using the index of orthognathic functional treatment needs (IOFTN)". Int J Pediatr Otorhinolaryngol. 79 (7): 1063–6. doi:10.1016/j.ijporl.2015.04.027. PMID 25957779.
- ^ Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016). "Functional needs of subjects with dentofacial deformities: A study using the index of orthognathic functional treatment need (IOFTN)". J Plast Reconstr Aesthet Surg. 69 (6): 796–801. doi:10.1016/j.bjps.2016.03.008. PMID 27068664.
- ^ Coceancig, Paul (2021). 6 Ways To Design A Face: corrective jaw surgery to optimize bite, airway, and facial balance. Batavia: Quintessence Publishing. ISBN 978-086715966-0.
- ^ Ireland AJ, Cunningham SJ, Petrie A, Cobourne MT, Acharya P, Sandy JR, Hunt NP (2014). "An index of orthognathic functional treatment need (IOFTN)". J Orthod. 41 (2): 77–83. PMID 24951095.
- ^ Borzabadi-Farahani, A (2023). "Systematic Review and Meta-Analysis of the Index of Orthognathic Functional Treatment Need for Detecting Subjects with Great Need for Orthognathic Surgery". Cleft Palate Craniofac J. doi:10.1177/10556656231216833. PMID 38037271.