What is Dentofacial Osteotomy: Overview, Benefits, and Expected Results

Definition & Overview

A dentofacial osteotomy, also known as an orthognathic surgery, is a corrective jaw surgery performed to correct dentofacial deformities. During the procedure, the surgeon cuts, moves, and realigns the bones of the jaw to achieve an improved facial and natural-looking appearance. It can be performed on either the upper or lower jaw, and used to resolve a wide range of maxillofacial problems.

Who Should Undergo and Expected Results

Dentofacial osteotomy is recommended for patients who suffer from dentofacial deformities, such as:

• Maxillary prognathisms
• Mandibular prognathisms
• Malocclusions
• Mandibular retrusion

Dentofacial deformities can make certain actions challenging for patients, and can also cause symptoms, such as:

• Open bites
• Pain related to temporomandibular joint disorder
• Excessive wear and tear of teeth
• Difficulty swallowing
• Difficulty chewing
• Receding chin
• Jaw pain

Dentofacial osteotomies have been in use since the 1940s. Due to the continuous development and improvement of the techniques used in this procedure, it has significantly evolved and is proven to be highly effective in correcting extreme jaw deformities. The procedure, which is sometimes combined with dental extractions, is also expected to relieve pain related to jaw disorders, including the very common temporomandibular joint disorder or TMJ.

In the past, an osteotomy was considered as a major surgery performed under general anaesthesia and full sedation, which requires patients to stay in the hospital for up to 2-3 days after the surgery. Nowadays, it is performed under local anaesthesia supported by intravenous sedation, essentially making it an outpatient procedure.

Aside from correcting jaw deformities and relieving painful jaw symptoms, patients who undergo the procedure can also expect minimal pain during surgery, no hospitalisation, and a short recovery period.

How is the Procedure Performed?

Dentofacial osteotomies are performed by a maxillofacial surgeon, usually on an outpatient basis. The specific manner in which it is performed differs depending on the specific problem at hand.

A maxilla osteotomy is used to resolve upper jaw deformities, such as an open bite. During the procedure, the surgeon makes an incision below the patient’s eye sockets to move and align the entire upper jaw correctly into its ideal position. The jaw is then stabilised using titanium screws.

A mandible osteotomy, on the other hand, is used to correct deformities affecting the lower jaw. During the procedure, the surgeon makes an incision behind and in between the first and second molars. The front jaw is then detached and the mandible is placed into the desired position. The jaw is secured with stabilisation screws, which will be removed once the patient is fully healed.

A bilateral sagittal split osteotomy is another type of dentofacial osteotomy and is, in fact, an indispensable tool for correcting dentofacial abnormalities. This procedure takes about two hours, with the patient under general anaesthesia. During the procedure, the surgeon makes a horizontal incision on the inner part of the ramus mandible going to the anterior portion of the ascending ramus, then continues it towards the descending ramus all the way to the lateral border of the mandible. The surgeon follows this up with a vertical cut along the body of the mandible towards the inferior border of the mandible. A chisel is then used to carefully split the mandible in half, after which it can then be moved forwards, backwards, or sideways. As with other types of osteotomies, the jaw is then stabilised with screws and wired shut for around 4 to 5 weeks.

Recovery following a dentofacial osteotomy may take around 2 to 6 weeks, but the patient’s bone will continue to heal gradually over a period of 2 to 4 months. The jaw may be immobilised for up to 1 month after the procedure, and may continue to heal for 2 to 3 months. Pain medications and antibiotics are typically prescribed to ensure patient comfort and prevent the risk of infection.

Possible Risks and Complications

Risks and potential complications linked with an osteotomy include:

• Nerve damage
• Bacterial infection – Studies show that the risk of infection is significantly higher among patients who undergo an osteotomy and a third molar extraction at the same time.

In general, however, the rate of complications related to the procedure has decreased significantly since more advanced surgical techniques were introduced.

References:

• Mills PB. “The orthodontist’s role in surgical correction of dentofacial deformities.” American Journal of Orthodontics. http://www.sciencedirect.com/science/article/pii/0002941669902772

• Nanda R., Sugawara J. “Mandibular adaptations following total maxillary osteotomy in adolescent monkeys.” American Journal of Orthodontics and Dentofacial Orthopedics. http://www.ajodo.org/article/S0002-9416(83)90247-6/abstract

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Title: ⁣Dentofacial Osteotomy⁣ – ‌Overview, Benefits, and Expected ‍Results



Question: What ‍is Dentofacial Osteotomy?



Answer: Dentofacial osteotomy is a‌ complex surgical procedure aimed ​at correcting severe skeletal discrepancies between the upper and lower jaws, thereby improving ‍dentofacial aesthetics and function. It⁣ involves strategically cutting and repositioning the bones of⁤ the jaw⁤ to achieve the desired alignment and facial balance.



### **SEO Keywords**:

– Dentofacial Osteotomy

– Orthognathic ⁢Surgery

– Jaw Surgery

– Facial Skeletal Discrepancy

– Orthognathic Surgery



Question: Why ⁣is Dentofacial Osteotomy⁤ Performed?



Answer: Dentofacial osteotomy is medically indicated for individuals suffering ⁣from skeletal, dental,⁣ and functional issues ​arising from severe misalignment between the upper and lower jaws. This‍ procedure ‌is often recommended in ‍cases involving:



– Unfavorable jaw positioning contributing to poor chewing and speaking difficulties

– Open bite or pronounced underbite‍ affecting facial aesthetics and dental function

– Severely misaligned jaws causing obstructed sleep apnea

– Facial trauma leading to facial bone fractures and deformities

– Cleft‌ lip and ⁢cleft palate situations



### **SEO Keywords**:

– Jaw Alignment

– Open ​Bite

– Underbite

– Obstructed ​Sleep Apnea

-⁣ Facial⁤ Deformities

– Cleft Lip and Cleft Palate



Question: ⁢What Are the Benefits of‌ Dentofacial Osteotomy?



Answer: Dentofacial osteotomy is a life-changing procedure offering numerous benefits beyond restoring facial balance and aesthetics. These include:



– Improved biting and chewing function

– Clearer speech

– Relief from chronic jaw ​pain

– Enhanced dental aesthetics and hygiene

– Reduced incidence of tooth ⁢grinding⁣ and jaw clenching

– Reduced​ risk of periodontal disease

– Improved sleep quality and‌ reduced airway obstruction leading to‌ better overall health



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– Functional Improvement

-⁤ Dental Aesthetics

– Periodontal Health

– ⁤Sleep Quality

– Airway Obstruction



Question: What Can I⁢ Expect ‍Before, During,​ and After Dentofacial Osteotomy?



Answer: The dentofacial osteotomy ‍process typically involves:



– Pre-Surgical Evaluation: A thorough examination of the jaw,⁣ teeth, and⁤ facial structures, including imaging studies, to create a personalized treatment plan.

– Surgical Procedure: Conducted under general anesthesia, the procedure involves precise cuts and repositioning ‌of bones to correct the skeletal misalignment. Temporary fixation is secured with plates, screws, or wires.

– ‌Post-Surgical Recovery: Recovery includes wearing​ appliances like elastics, and dietary modifications for the⁣ initial weeks to protect healing bones and⁤ promote tissue regeneration.



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– Pre-Surgical⁣ Examinations

– Custom Treatment Plan

– General Anesthesia

Temporary Fixation

– Dietary Modifications



Question: When ⁢Can I Expect to See Expected Results from Dentofacial Osteotomy?



Answer:​ While results are typically visible soon after surgery, the ⁣final, refined outcome of the ‌dentofacial osteotomy can take ⁤several months to fully manifest. This is due ⁢to the gradual ⁣healing process of bones and tissues, with complete stability achieved over time.



However, patients often experience notable improvements in functionality and aesthetics within the first few weeks, as swelling subsides, and ⁤healing progresses.



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– Outcome Timeline

– Healing Process

– Functional Improvement Timeline