Dentofacial Program
The OSU Dentofacial Program
The OSU Dentofacial Program was established in order to provide a
team approach to the management of patients with dentofacial
problems. There are team coordinators consisting of an orthodontist
and an oral and maxillofacial surgeon at OSU. Your specific orthodontist
or oral surgeon who provides your treatment may be different from
these doctors.
After an initial visit, which may include the gathering of information,
including x-rays, dental models and photographs, your "case"
will be presented at a combined conference of orthodontists and oral
surgeons to develop the best treatment plan for you. The proposed
treatment plan will then be presented to you and your family to appointment.
Bite Problems of the Teeth and Jaws
Many people have a malocclusion or bite problem, where the
jaws and/or teeth do not line up properly. Many bite problems are
treated successfully with braces (orthodontic treatment) because braces
move teeth within the jaw bone. If there is a problem with the size,
shape or position of the jaw bones themselves, a surgical procedure
(oral surgery) may be needed. However, oral surgery cannot straighten
teeth by itself. Therefore, to place the teeth and the jaws in the
correct relationship to each other, it is usually necessary to perform
oral surgery in conjunction with orthodontics. This combined approach
is commonly referred to as surgical orthodontics.
Most patients need surgery in one jaw only. Occasionally, repositioning
both jaws is necessary. The orthodontist and oral and maxillofacial
surgeon will work together to give you the most functional and pleasing
results.
Why a Combined Orthodontic-Surgical Treatment Plan?
An orthognathic surgical approach may be preferable for patients
whose teeth can be straightened with braces, but whose jaws would
remain out of alignment. Instability may occur later from placing
the teeth in an abnormal relationship to the jaws. It is preferable
to first straighten the teeth within each jaw using braces and then
to correct the jaw problem with oral surgery. This method produces
a more stable and ideal result.
How Long Will Treatment Take?
After a treatment plan is developed, the length of treatment usually
depends on the severity of the problem. During the orthodontic or
pre-surgical phase, patients usually wear braces 12 to 18 months to
align the teeth properly. The patient’s age, how quickly the
teeth move and the patient’s cooperation all affect the length
of treatment time. During this time, the orthodontist and oral surgeon
communicate regarding treatment progress.
Patients usually see the orthodontist monthly during orthodontic
treatment. Your dentist will also need to see you periodically during
treatment for "cleaning" and general dental care. When the
teeth are aligned properly, the patient undergoes the planned surgical
procedure. In the post-surgical phase of therapy, the patient will
continue to wear braces after surgery to adjust the teeth while they
settle in their new position. This usually takes between 4 and 6 months
after surgery. Proper follow-up office visits are very important during
all phases of treatment.
Tell Me About Surgery
If surgery becomes an option for treatment, you and your surgeon
can review your medical insurance to determine whether it covers the
proposed orthognathic surgery. You may be admitted to a hospital for
care or you may have outpatient surgery. Surgery is performed under
general anesthesia, during which time your surgeon will move your
jaw bones into correct relationships. All surgical procedures are
performed inside your mouth, without visible facial scars. Since miniature
plates and screws hold the bones in place, the jaw(s) are not usually
wired shut. Surgery usually takes from 2 to 5 hours depending upon
the specific procedure. In most cases, you will either spend one night
in the hospital or remain in the recovery room for observation after
surgery. Following surgery, you can expect some swelling which can
be controlled with medications and ice packs. Some minor bleeding
is common and bruising may also occur. Most patients actually have
less pain than they expect, since the jaw bones are usually numb immediately
after surgery. In general, patients return to a normal level of activity
(e.g., work, school) as early as one week following surgery.
Will There Be Changes in My Appearance After Surgery?
The combined orthodontic-surgical process typically results in some
changes to the patient’s facial appearance. If the jaw imbalance
is severe, the resulting changes will be more obvious. These changes
are considered to be favorable, resulting in a more pleasing appearance.
Facial changes produced by treatment usually are predictable, and
the doctors will discuss them in detail with each patient. The doctors
recommend only those surgical procedures that should result in a more
harmonious, favorable aesthetic and functional occlusal change.
