What are the indications of orthognathic surgery, and how long does it take?

Question

Hello doctor,

I am attaching the X-rays of my teeth. Is orthognathic surgery possible in my case? If not, why? How long does it take for orthodontic treatment to be done? Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Hope you are doing well. Based on the photos attached (attachments removed to protect the patient's identity), there is a deficiency in your lower and middle face compared to the forehead area. However, these are X-ray images, and I would like to see the clinical photos as well to be able to guide you better on the most appropriate treatment approach. Yes, the orthognathic approach is possible in most cases. I could see in the images that your upper front teeth are slightly inclined inward. Therefore, we need a slight leveling of the teeth to proceed with surgery. Once we get the particular teeth upright, we can proceed with the surgical procedure. The whole treatment can be divided into three phases. Pre-surgical phase - In this phase, we will upright the teeth and prepare for surgery. Surgical phase - Surgery will be done in this phase. Post-surgical phase - We will be doing refinements and further detailing of the dentition after surgery. Kindly share your related concerns and clarifications if required.

Answer 2

Hello,

Welcome back to icliniq.com.

As you have already started using braces, it should take about a month or two to get the desired torque. The treatment plan provided to you before surgery is called the orthodontics first approach, wherein most alignments and teeth corrections are done before the surgical procedure. Once the surgery is done, they will do the final settling and minor intermaxillary adjustments as required. However, you are willing to a surgery. Even for your approach, I would suggest getting points 1 and 2 done before surgery (leveling and torsion). But one important point to consider is that four of your teeth have been extracted. I do not know why they were extracted. Based on your profile, there was no need for tooth extraction. This, in my opinion, is a wrong decision. However, we cannot regain the lost teeth. However, we can only do what is best based on current situations and available resources. Ask the treating doctor why extraction was done when surgery was already planned. We need to know their viewpoint as well. Which method will they use for extraction space closure - protraction (bringing back teeth forward) or retraction (taking front teeth back)? These points should be discussed before deciding how things should proceed for you.