Procedur in Orthognatic Surgery

In orthognathic surgery, an osteotomy (bone cut) is made in the affected jaw, and the bones are repositioned in a more normal alignment. Generally, the bones are held in their new positions with plates, screws and wires. The patient may also need arch bars placed on both jaws to add stability (a procedure called intermaxillary fixation). For patients with deformities in both jaws, simultaneous osteotomies may be undertaken to achieve correction. Patients with deficient bone or soft tissues of the face may require distraction osteogenesis. A distraction device is applied. Bone osteotomies are performed. The distraction device is then used to slowly apply a distractive force at the osteotomy site until new bone is formed. Once the desired reconstruction is achieved, the device is left in place until the bone is healed and then the device is removed. This enables a surgeon to elongate a facial bone and the adjacent soft tissue envelope. Patients with deficient bone tissue may require grafts from their ribs, hips or skull. Alloplastic replacement of missing bone may also be required. The preparation of a donor site and the harvesting of the patient’s own bone requires additional cognitive effort and surgical time on the part of the physician.