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Corrective Jaw Surgery (Orthognathic Surgery)

Orthognathic surgery refers to the surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area.

Orthognathic surgery is generally performed by an Oral and Maxillofacial Surgeon to correct malocclusion (bad bite) in cases where routine orthodontic treatment has not or will not be effective. Orthognathic surgeries include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy.

There are several classifications of malocclusion (the improper coming together of teeth) which may require orthognathic surgery:

Class I Occlusion –This malocclusion means that the lower anterior incisors sit directly behind the upper anterior incisors when the patient bites down. This is considered less destructive than Class II and Class III malocclusions.

Class II Malocclusion – This is identified when the lower anterior incisors lie significantly behind the upper anterior incisors during the biting process; in some cases hitting the soft tissue behind the upper incisors. This is commonly referred to as an overbite and can cause discomfort, bone damage, excessive wear of the front teeth, and tooth loss.

Class III Malocclusion – This is commonly known as an underbite and occurs when the lower anterior incisors and lower jaw are positioned beyond the upper teeth, making the lower jaw much more prominent than the upper jaw.

Reasons for orthognathic surgery

The malocclusion of the teeth can create greatly destructive forces among the five powerful muscles that control the closing and opening of the jaw. These muscles generate a tremendous force when clenching, grinding or chewing. Misalignment can seriously damage the function and aesthetic appearance of the teeth in many ways if left untreated, such as:

  • Tooth Wear – In the case of an overbite, the pressure and wear on the teeth is not spread evenly. This can also lead to TMJ, migraine headaches, and tooth loss.
  • Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth alters the way the facial muscles interact. In some cases, the meniscus cartilage which acts as a buffer between the jawbones can be painfully damaged.
  • Loose Teeth – When uneven pressure is continually exerted in unintended places or soft tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain and reduces proper function.
  • Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods are eaten.
  • Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor alignment of the upper and lower jaws.

What does orthognathic surgery involve?

When the dentist identifies a patient as a candidate for orthognathic surgery, a complete photographic analysis is initially undertaken. This includes panorex x-rays, cephalometric x-rays, models, impressions, and radiographs. Your oral & maxillofacial surgeon, your orthodontist and your dentist will work together and consider how the corrective surgery will impact both proper jaw function and the aesthetic appearance of the entire face.

Generally, orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You may also be provided with a modified diet (if required).

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Dear Dr. Muduli ,

I want to take this opportunity to thank you for the excellent care and attention given to me during my office visit. I really appreciate your kind consideration and review of my medical condition. The time taken to explain to me the various options and your expert opinion is greatly appreciated. You have demonstrated to me your wisdom and knowledge of the profession. Once again, thanks for helping me and giving me high quality care and attention.

Peter

Dear Dr. Muduli,
I will write to you with warm and sincere thanks for extracting my wisdom teeth. I must say that you exemplify a superior level of professionalism, proficiency and confidence when you work. I was initially very apprehensive at the start of the procedure. However you and your staff were able to relax and provide me reassurance. You performed outstandingly and for that I am very grateful.
Please know that I will proudly recommend you to anyone that I should encounter who may require your services. You exhibit truly iconic poise and are a model to be replicated. Despite this, I do sincerely hope I never have to see you again. Once more, my deepest thanks and best regards.

Christopher

Top qualities: Great Results, Expert, High Integrity

“The quintessential professional in his field; Dr. Muduli's attention to detail, his superior skill, and unparalleled bedside manner make him a rare find in a competitive and sometimes confusing arena of Oral & Maxillofacial Surgery. My first experience with his professionalism and skill was when Dr. Muduli's comforting and professional approach put my son at ease while treating him for a difficult procedure to remove significantly impacted wisdom teeth. At the time his practice was local to me. The results were excellent. I was so pleased with how he cared for my son that when I needed extensive maxillofacial treatment I made the trip to his new office 23 miles from my home. A worthwhile trip I would readily do again. Bobby is a health professional I trust with my children and will gladly go out of my way in terms of travel for his services. I highly recommend him.” November 8, 2011

Francis

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