Orthognathic (maxillo-facial) surgery to correct malformations and / or deformities of the jaws
Such surgery is indicated when the limits of orthodontics are reached. That means: when moving teeth is not enough to improve the dental and skeletal discrepancies that one often sees in association with clefts of the lip and/or palate.
Even then, orthodontics remains an indispensable complementary therapy. In fact, pre-surgical orthodontics must make it possible to prepare the dental arches according to the orthognathic treatment plan.
This treatment plan is based on clinical data (profile analysis, inter-maxillary relationships) and cephalometric data (profile teleradiography, laboratory and digital surgical simulation).
Orthognathic surgical planning
Surgical planning is established according to the timing of the intervention, which must be preceded by a period of orthodontic preparation.
Surgery of this type can be considered after the end of pubertal growth, that is, after 16-17 years for girls, 17-18 years for boys.
The management of a combined orthodontic / orthognathic treatment takes place in 3 phases:
1) Pre-surgical orthodontics: duration: 12 to 18 months.
2) Osteotomy: mono- or bi-maxillary: maxillary (upper jaw)(also known as Lefort I osteotomy) advancement, in 1, 2 or 3 parts combined with a pushback mandibular osteotomy ± genioplasty.
3) Orthodontic finishing: duration: 6 to 12 months.
Georges Herzog, consultant orthodontist for the multi-disciplinary FLMP team at CHUV (Lausanne), contact: firstname.lastname@example.org