When Is Double Jaw Surgery Needed?

Double Jaw Surgery: When Is Needed?

One of the specialties of Dr. Wintergerst and his team of medical professionals is bimaxillary orthognathic surgery. This type of surgery is one in which the aim is to move the jaw towards a more adequate position, both aesthetically and functionally, by means of a medical-dental combination, that is, orthodontics that moves the teeth and maxillofacial surgery that moves the bones.

This type of surgery, therefore, requires three-dimensional movements of both the maxilla and the mandible to achieve the correct bite and recover the patient’s masticatory and esthetic function.

Currently, these dento-facial deformities affect 10% of the world’s population presenting imbalances related to the teeth and face. Fortunately, in Mexico, the DrAW Dental Clinic is a reference in the performance of this surgical procedure.

 

 

The importance of a good diagnosis

 

However, to achieve the best final results in the patient it is necessary to make an accurate diagnosis using the latest technology tools such as three-dimensional studies that allow a scan of the entire oral and maxillofacial area that can be managed by software to accurately plan the treatment. It is precisely this planning that is one of the most important factors in bimaxillary surgery, since the maxillofacial expert can prepare all the surgical movements in advance on the virtual model and test possible movements of the facial bones and thus be able to see the different treatment possibilities before the intervention.

It is also important for the patient to participate in the process as he or she can assimilate and be aware in advance of the type of intervention to be performed.

 

Analysis according to pathology

 

First of all, it is important to know that, prior to orthognathic surgery, orthodontic treatment is carried out to achieve movement of the teeth. Subsequently, maxillofacial surgery is performed to treat the bones. This is achieved through a treatment that includes three-dimensional movements of the mandible and maxilla.

There is a three-dimensional study that is performed beforehand that allows the maxillofacial surgeon to plan the treatment properly. He can “virtually” prepare the movements to be performed on the bones and, thus, know the different possible treatment options.

However, depending on each pathology, different cephalometric analyses can be performed:

• Simple: guides visually and audibly so that the surgeon can establish the best reference points. This wizard also has the option to alter the configuration of existing analyses or to create your own analyses.
• Predictable: provides a 3D environment for easy and simple landmark identification, allowing you to diagnose the patient’s anatomy.
• Complete: all available elements such as measurement tools, annotations… are used to analyze the area to be treated and to be able to make an accurate diagnosis and subsequent intervention.

As an additional method of assistance, we also have digital repositioners that are manufactured with a 3D printer that facilitates the correct positioning of the arch during surgery. Therefore, through virtual planning, the repositioners for bimaxillary treatments, together with the team of specialized professionals and the state-of-the-art facilities, will provide a perfect result.

 

When is bimaxillary surgery needed?

 

It is important to keep in mind that there are different orthognathic surgeries, but all of them have in common the maxillary and mandibular treatment with an aesthetic and functional purpose.

Double Jaw Surgery is indicated in cases of:

• Malocclusion in which the maxilla and mandible are affected. There are class II, class III and open bite malocclusions. Bimaxillary surgery is indicated when the malocclusion is of bony origin.
• Repositioning of the bones in the most appropriate position according to the desired aesthetic objective.
• Obstructive sleep apnea.

The patient has from the first consultation with the entire team of experts at his disposal for any questions.

From the first moment, all treatment options are explained and the best one for each case. Therefore, do not hesitate to come and visit us at our facilities in Tijuana for a personalized diagnosis according to your needs.

 

Double Jaw Surgery: Step by Step

 

While our patients always know in advance the procedures that will be performed during their surgery, many of them would like to know exactly what happens once the anesthesia takes effect. Here we explain step by step how bimaxillary orthognathic surgery under general anesthesia is performed at the DrAW Dental Clinic:

After their hospital admission, patients are taken to the Induction Room, where an IV is placed to administer the relevant drugs, as well as a mild sedative that decreases anxiety and helps the patient to relax.

Once this medication has been administered, the patient enters the operating room 30 minutes before surgery. During this time, they are given inhaled anesthetic gases by means of a mask that lulls the patient into a pleasant state of numbness, then intubation is performed.

The following people will be present in the operating room:

• Surgeon: is the only one who will be in charge of all surgical procedures (cuts, bone repositioning, sutures, etc.).
• First Assistant: (surgeon) is in charge of the main assistantship: tissue separation, aspiration, etc.
• Second Assistant: (resident physician) reinforcement of the assistantship.
• Anesthesiologist: in charge of defining the drugs (type and quantity) for anesthesia, intubation and monitoring the patient’s vital signs throughout the surgery, as well as in the moments before and immediately after it.
• Nurse Anesthetist: prepares medication, IV placement, etc.
• Instrumentalist: prepares surgical material and assists the surgeon.
• Circulator: provides the scrub nurse with material that is outside the surgical area.
• Observers: in some surgeries. Usually medical students or in some cases the patient’s orthodontist or visiting physicians. They are in the operating room at a safe distance from the surgical area and cannot intervene for any reason.

Once the anesthesia has taken effect, the surgical time begins to run. In bimaxillary orthognathic surgery (mandible + maxilla), the surgeon usually starts with the mandible.

For mandibular procedures, a Bilateral Sagittal Osteotomy (BSSO) is usually performed, which are two inverted L-shaped cuts on each side of the mandible that begin in the area of the wisdom teeth, continue horizontally to the second molar, and then descend vertically. These cuts allow the maxillofacial surgeon to advance, retard or rotate the mandible.

For the maxilla, the most common procedure is a Le Fort I osteotomy, a cut in the bone that goes from the base of the nose in both directions to the junction of the maxilla. This cut allows the shape and position of the maxilla to be modified in three dimensions, allowing it to be lengthened, shortened, advanced or retracted.

After the jaw and maxillary adjustments are completed, we proceed, if any, with the aesthetic procedures required to achieve greater harmony in the patient’s face.

The surgical time ends with the last suture, where previously the anesthesiologist has begun a process of decreasing the anesthesia to gradually awaken the patient, a process that lasts between 10 and 15 minutes. Once the patient begins to breathe on his own, the intubation tube is removed and a stretcher-bearer takes the patient to the resuscitation area, where he will be observed for approximately 2 hours before going up to his hospital room to begin his recovery.

It is important to emphasize that, thanks to the great experience of our medical team and the minimally invasive techniques we use, surgical times at DrAW Dental Clinic are notably shorter than at other sites, resulting in a much shorter and less uncomfortable postoperative period for the patient.

 

DO YOU THINK YOU NEED DOUBLE JAW SURGERY?  

 

Payment facilities in DrAW Dental

 

At DrAW Dental Clinic we offer our patients very flexible and attractive payment conditions:

• Financing of 100% of the treatment ask how
• Discounts for early payment

 

If you have further questions or wish to receive a diagnosis about your case, we advise you to contact our clinic.

Once you have made an appointment, Dr. Wintergerst will be able to answer all your questions and explain the planning of your treatment.

Remember that it is not only a question of aesthetics, but of health, and that undergoing this surgery can change your life completely.

 

If you need our doctors to assess the state of your oral health, don’t let it pass you by and make an appointment.

Call us at +1 619 372 5409 🇺🇸 +52 664 590 8321 🇲🇽 , or use the contact form on our website, and ask for your first free appointment.

We will give you a complete diagnosis and an estimate without obligation.

 

You will be interested in » Maxillofacial surgery: what operations does it include?

 

Read Our Orthognathic Surgery Guide

 

At DrAW Dental Clinic we are guided by editorial guidelines that ensure the accuracy of all the information we publish. If you would like to know more about how we ensure that our content is up-to-date and properly supported, we encourage you to read our editorial commitment.

 

 

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