In order for a person to perform a good speech and nutritional function, healthy tooth closure and proper biting are required. This, in turn, is possible with the harmony of the upper and lower jaw with each other. When the mouth is closed, the teeth in the lower jaw (Mandible) should fit into their appropriate tooth sockets behind the teeth in the upper jaw (Maxilla) (Normal bite or closing). If the bite goes beyond normal (malocclusion), problems with speech and nutritional functions may occur, as well as deformations on the bilateral jaw joint, which can progress over time and cause major problems. Sometimes it causes snoring and breathing problems. In addition, the fact that the person’s lower jaw is behind the normal (class-II malocclusion) or ahead (Class-III malocclusion) also sedately negatively affects the appearance of the face and can lead to a decrease in the person’s self-confidence.

Treatment of bite disorders is basically performed in two ways. The first of these is a non-surgical treatment applied by orthodontists who have specialized in Orthodontics in the Faculty of Dentistry. Mild bite disorders can be treated in this way. The second treatment option is surgery. The point that should not be forgotten here is that the patient should be prepared for surgery again accompanied by an orthodontist. Preoperative orthodontic treatment can last up to a year and during this period, the patient, orthodontist and plastic surgeon are in constant communication. Surgery to be performed on the patient is clarified at the end of orthodontic treatment; only the upper jaw can be intervened, only the lower jaw can be intervened, or both jaws may need to be intervened. In addition to all these, to achieve optimal facial ratios, additional jaw tip surgery(genioplasty) may be required in some patients. 

Preparation For Surgery

Detailed examination of the patient is the first and most important step. After a detailed examination, strict follow-ups begin accompanied by an orthodontist. The general condition of the patient, accompanying diseases, medications used, and whether expectations are realistic are the most important points for us. Detailed examination together with the anesthesiologist is a must for pre-operative preparation. If the patient smokes, it is recommended to stop 3 weeks beforehand, and blood thinners to be discontinued before the specified time. Preoperative planning is an important step for surgical preparation.

Method Of Surgery

The operation is performed under general anaesthesia and its duration is between 2-5 hours depending on the extent of the procedures to be performed. All interventions are performed through incisions made inside the mouth. Most of the cases referred to us in the clinic are candidates for “double jaw” surgery, which requires both the upper and lower jaw to be cut and fixated in the correct place. In this operation, primarily, the jaw is separated from all bone connections for the upper jaw by entering the incision made in the mouth. In this operation, primarily, the jaw is separated from all bone connections by entering the incision made in the mouth for the upper jaw. Then, the decal (splint) prepared by the orthodontist is attached to the jaw and the upper jaw is fixed in its correct place by means of titanium plate screws. After this, the lower jaw is reached and separated from all bone connections and fixed in its correct place with the help of the final splint.

Healing Process

At the end of the surgery,  proper bite is checked and the patient is taken to bed. Patients stay in the hospital for 2 or 3 nights after surgery and receive appropriate oedema reduction treatment in this process, and their jaws are tied together with elastic bands so that their teeth are in the appropriate position and discharged to go to the orthodontic doctor.

After discharge, as before the surgery, the examinations to be performed by the plastic surgeon and orthodontist begin. During the recovery period, the orthodontist keeps track of the patient in terms of some modifications that will ensure optimal healing, especially keeping the upper jaw and lower jaw connected to each other. The plastic surgeon, on the other hand, performs surgical follow-up, such as healing of the suture lines, condition of oedema on the face. In general, the patient can return to his routine life in the 3rd week after the operation, and between 3-6 months, final result can be observed when facial oedema is completely decayed. 

Orthognathic surgery is one of the most challenging operations of plastic surgery, but it is also one of the most satisfying operations. In addition to the extent of the surgery, complications that may cause the need for additional surgical interventions can be encountered after the surgery. The preparation period, which can take up to one year before the operation, and the recovery period, which lasts for about a month after the operation, should be taken into account, and the patient should talk to his doctor in detail and decide clearly whether he really wants to go on this path. Although the path to go through is quite strenuous, the aesthetic and functional result obtained after successful surgery is extremely satisfactory.