Many children these days will at some point during their development are recommended for orthodontic treatment or braces. Most of these patients will be routine cases for any orthodontist to handle. A small percentage of these patients however will be evaluated for a significant malocclusion. Occlusion is the way that your teeth come together. People with significant malocclusion will be either one of two types. Type 2 patients have a significant overbite, having the lower teeth positioned well behind the upper teeth. Type 3 patients have a significant underbite which has the lower teeth positioned forward of the upper teeth. Both of these conditions can be caused by overgrowth or undergrowth of either the upper jaw, lower jaw or both. This condition is referred to as a skeletal malocclusion. If these conditions are caught early by the orthodontist initial attempts to guide the bone growth of the face and jaws with appliances such as braces, headgear, retainers etc., can be attempted. Once the majority of the skeletal growth is completed in the teenage years correction of the misalignment of the jaws may require surgery.
Surgery to reposition the facial bones, teeth and jaws is called orthognathic surgery. This can be a life altering surgery for patients who cannot chew food properly or are concerned about their facial esthetics due to abnormal jaw position. Many types of cosmetic smile and facial profile issues can be aided through orthognathic surgery. Patients that show an excessive amount of gum tissue when smiling often suffer from a condition called vertical maxillary excess which can be surgically corrected. Patients whose lower jaw and chin are pronounced may suffer from mandibular hyperplasia or maxillary hypoplasia which will cause a very flat or concave appearance to the face. Patients with a weak chin may suffer from maxillary hyperplasia, mandibular hypoplasia or geniohypoplasia causing a convex appearance to the facial profile. Finally patients with a significant asymmetry to the facial appearance can suffer from one of several developmental syndromes or conditions that limit the growth of one side of the jaws or may have significant overgrowth of one area of the jaw requiring recontouring or orthognathic surgery to correct.
All of these conditions can be managed through a joint effort between the oral surgeon and the orthodontist. Several months of planning and workup of the conditions, planned procedures, diagnosis are done prior to any surgical intervention. The surgery can be very involved and there is a significant recovery period after the surgery but for those patients that require the surgery the functional and esthetic outcomes are tremendous. If you suspect a problem with you or your child, or if your orthodontist has discussed the possible need for surgery it may be a good idea to discuss your treatment with one of our surgeons here in Pottstown Oral and Maxillofacial Surgery Associates.