Orthognathic treatment is a combination of orthodontics and maxillofacial surgery. It is applied to patients whose malocclusion results not only from incorrect tooth positioning but also from an improper relationship between the maxilla and mandible. In such cases, orthodontic appliance treatment alone may not be sufficient, as the problem also involves the facial bones.
Orthodontic preparation is one of the key stages of orthognathic treatment. Its goal is to position the teeth in such a way that the surgeon can properly plan and perform the surgical procedure, and achieve a stable, functional bite after treatment.
What is Orthognathic Treatment?
Orthognathic treatment involves correcting the improper positioning of the maxilla, mandible, or both bones relative to each other. It may be indicated, among others, in patients with severe prognathism, retrognathism, open bite, facial asymmetry, or other skeletal discrepancies that affect bite function, chewing, speech, breathing, and facial aesthetics.
In practice, orthognathic treatment requires cooperation between an orthodontist and a maxillofacial surgeon. The orthodontist prepares the teeth for the procedure, and the surgeon performs the bone repositioning. After surgery, orthodontic treatment is usually continued to refine the bite details.
More information about this scope of treatment can be found on the page:
Orthognathics at Stomo Clinic
Why is orthodontic treatment needed before orthognathic surgery?
Before an orthognathic procedure, the teeth must be positioned in a way that allows for the correct alignment of the dental arches after surgical repositioning of the maxilla or mandible. This is important because the discrepancy visible in the teeth is often only part of a larger problem.
In many patients, the body compensates for a skeletal discrepancy for years. This means that the teeth position themselves in a way that partially masks the improper jaw relationship. Before surgery, the orthodontist often has to “reverse” this compensation — that is, prepare the teeth for the correct bone positioning during the procedure.
It sounds a bit like taking one step back to take three steps forward. And that’s exactly what it is.
What does orthodontic preparation for an orthognathic procedure involve?
Orthodontic preparation begins with thorough diagnostics. The orthodontist assesses the bite, tooth alignment, facial features, X-rays, scans or models of the teeth, and the relationship between the maxilla and mandible. Based on this, a treatment plan is developed, which should include both the orthodontic and surgical stages.
Treatment most often includes:
- analysis of malocclusion and facial proportions,
- preparation of dental arches for surgery,
- positioning of teeth in the correct relation to the bones,
- cooperation between the orthodontist and the maxillofacial surgeon,
- orthognathic procedure,
- continuation of orthodontic treatment after surgery,
- stabilization of treatment effects.
In many cases, the patient wears fixed braces before surgery. The braces also remain on the teeth during and after the procedure, as they help in precise bite alignment and subsequent refinement of contacts between the teeth.
How long does orthodontic preparation for surgery take?
The duration of preparation depends on the type and severity of the discrepancy, the patient’s age, the condition of the teeth and periodontium, and the planned scope of surgical treatment. For some patients, preparation may take several months, for others longer.
It is not possible to responsibly provide a single universal timeframe, as orthognathic treatment is planned individually. This is not a “come in, fix it, leave” type of procedure. Here, the sequence of actions must be well-planned, otherwise, a bigger mess than before treatment can be created.
Can orthodontic treatment before surgery worsen the appearance of the bite?
At a certain stage, the patient may feel that the discrepancy looks more visible than before. This does not always happen, but it is possible, especially when the orthodontist removes previous dental compensations.
This is a normal element of preparation for surgery. The goal is not a temporary “nice alignment” of the teeth before the procedure, but to create conditions for the correct positioning of the maxilla and mandible during surgery.
That is why it is so important for the patient to understand the entire treatment plan from the beginning — not just the immediate stage, but also the ultimate goal.
When might orthognathic surgery be needed?
An orthodontic-orthognathic consultation may be indicated when the malocclusion is severe and affects function or facial proportions. This particularly applies to situations where there is:
- significant prognathism,
- severe retrognathism,
- open bite,
- facial asymmetry,
- difficulty chewing or biting,
- problems with lip closure,
- improper relationship between the maxilla and mandible,
- malocclusion that cannot be effectively corrected with orthodontic braces alone.
Final qualification always requires diagnosis and specialist consultation.
Does every patient with malocclusion require surgery?
No. Most malocclusions can be treated orthodontically, without an orthognathic procedure. Surgery is considered when the problem is skeletal in nature, meaning it results from the structure and relative position of the bones, and not just from the alignment of the teeth.
Therefore, the first step should be a consultation and diagnosis. Only after analysis can it be determined whether orthodontic treatment alone will suffice, or if combined orthodontic-surgical treatment will be necessary.
Orthodontics and Surgery — Why is Cooperation So Important?
In orthognathic treatment, the orthodontist and surgeon must work according to a common plan. The orthodontist prepares the teeth for surgery, but does so with consideration for how the maxilla and mandible will be positioned relative to each other after the procedure. The surgeon, in turn, performs the bone correction according to the functional and aesthetic plan.
This treatment requires precision, communication, and patience. It cannot be done well “by eye.” The patient should know the stages, the goal of the treatment, and what to expect along the way.
Costs of Surgical Treatment
The cost of treatment depends on the scope of procedures, diagnostics, treatment plan, and the individual patient’s situation. For surgical procedures, the price may vary depending on the type of procedure performed and its complexity.
Current information regarding the costs of procedures can be found in the price list:
Dental Surgery Price List
Summary
Orthodontic preparation for an orthognathic procedure is an important stage in the treatment of patients with severe skeletal discrepancies. Its goal is not only to align the teeth but, above all, to create conditions for the correct correction of the maxilla, mandible, or both bones during the procedure.
Orthognathic treatment requires an individual plan, thorough diagnostics, and cooperation between the orthodontist and surgeon. Therefore, a patient who suspects a skeletal discrepancy should start with a specialist consultation and discuss the possible stages of treatment.
FAQ – Orthodontic Preparation for Orthognathic Procedures
Is an orthodontic appliance needed before an orthognathic procedure?
Most often, yes. An orthodontic appliance prepares the teeth for the correct positioning of the maxilla and mandible during surgery. This allows for a stable, functional bite to be achieved after the procedure.
How long does orthodontic preparation for orthognathic surgery take?
The duration of treatment depends on the type and severity of the discrepancy. For some patients, preparation takes several months, for others longer. A precise plan can only be determined after orthodontic and surgical diagnostics.
Does orthognathic treatment always require surgery?
Not every malocclusion requires surgery. An orthognathic procedure is mainly considered when the problem results from an improper relationship between the maxilla and mandible, and not just from the alignment of the teeth.
Do the braces stay on the teeth during surgery?
In many cases, the braces remain on the teeth during and after the procedure. They help the surgeon and orthodontist in correctly aligning the bite and subsequently refining the treatment outcome.
When should you consult about orthognathics?
A consultation is worth considering for severe prognathism, retrognathism, open bite, facial asymmetry, or difficulties with biting and chewing. Specialist diagnostics determine qualification.
