The OSU Dentofacial Program
The OSU Dentofacial Program was established in order to provide a team approach to the management of patients with dentofacial problems. There are team coordinators consisting of an orthodontist and an oral and maxillofacial surgeon at OSU. Your specific orthodontist or oral surgeon who provides your treatment may be different from these doctors.
After an initial visit, which may include the gathering of information, including x-rays, dental models and photographs, your "case" will be presented at a combined conference of orthodontists and oral surgeons to develop the best treatment plan for you. The proposed treatment plan will then be presented to you and your family to appointment.
Bite Problems of the Teeth and Jaws
Many people have a malocclusion or bite problem, where the jaws and/or teeth do not line up properly. Many bite problems are treated successfully with braces (orthodontic treatment) because braces move teeth within the jaw bone. If there is a problem with the size, shape or position of the jaw bones themselves, a surgical procedure (oral surgery) may be needed. However, oral surgery cannot straighten teeth by itself. Therefore, to place the teeth and the jaws in the correct relationship to each other, it is usually necessary to perform oral surgery in conjunction with orthodontics. This combined approach is commonly referred to as surgical orthodontics.
Most patients need surgery in one jaw only. Occasionally, repositioning both jaws is necessary. The orthodontist and oral and maxillofacial surgeon will work together to give you the most functional and pleasing results.
Why a Combined Orthodontic-Surgical Treatment Plan?
An orthognathic surgical approach may be preferable for patients whose teeth can be straightened with braces, but whose jaws would remain out of alignment. Instability may occur later from placing the teeth in an abnormal relationship to the jaws. It is preferable to first straighten the teeth within each jaw using braces and then to correct the jaw problem with oral surgery. This method produces a more stable and ideal result.
How Long Will Treatment Take?
After a treatment plan is developed, the length of treatment usually depends on the severity of the problem. During the orthodontic or pre-surgical phase, patients usually wear braces 12 to 18 months to align the teeth properly. The patient’s age, how quickly the teeth move and the patient’s cooperation all affect the length of treatment time. During this time, the orthodontist and oral surgeon communicate regarding treatment progress.
Patients usually see the orthodontist monthly during orthodontic treatment. Your dentist will also need to see you periodically during treatment for "cleaning" and general dental care. When the teeth are aligned properly, the patient undergoes the planned surgical procedure. In the post-surgical phase of therapy, the patient will continue to wear braces after surgery to adjust the teeth while they settle in their new position. This usually takes between 4 and 6 months after surgery. Proper follow-up office visits are very important during all phases of treatment.
Tell Me About Surgery
If surgery becomes an option for treatment, you and your surgeon can review your medical insurance to determine whether it covers the proposed orthognathic surgery. You may be admitted to a hospital for care or you may have outpatient surgery. Surgery is performed under general anesthesia, during which time your surgeon will move your jaw bones into correct relationships. All surgical procedures are performed inside your mouth, without visible facial scars. Since miniature plates and screws hold the bones in place, the jaw(s) are not usually wired shut. Surgery usually takes from 2 to 5 hours depending upon the specific procedure. In most cases, you will either spend one night in the hospital or remain in the recovery room for observation after surgery. Following surgery, you can expect some swelling which can be controlled with medications and ice packs. Some minor bleeding is common and bruising may also occur. Most patients actually have less pain than they expect, since the jaw bones are usually numb immediately after surgery. In general, patients return to a normal level of activity (e.g., work, school) as early as one week following surgery.
Will There Be Changes in My Appearance After Surgery?
The combined orthodontic-surgical process typically results in some changes to the patient’s facial appearance. If the jaw imbalance is severe, the resulting changes will be more obvious. These changes are considered to be favorable, resulting in a more pleasing appearance. Facial changes produced by treatment usually are predictable, and the doctors will discuss them in detail with each patient. The doctors recommend only those surgical procedures that should result in a more harmonious, favorable aesthetic and functional occlusal change.