An orthodontic defect is a defect in the tooth position or the jaw position or in both. Such a deviation is often not pathological in itself, unhealthy. Jaw and tooth position deviations cannot be found harmonious and not beautiful. Sometimes it results in complaints; for example, problems with chewing, talking, biting and jaw joint complaints at a later age.
It is best to have an orthodontic treatment at a young age. Then it is still possible to use the growth of the patient for the treatment. When orthodontic equipment, such as a headgear or activator, is used, the growth of the maxillofacial complex can be affected. This influence on growth is only possible if a patient is still growing.
In addition to being able to influence growth and direction of growth, teeth can also be moved separately. In an adult this is the only option for orthodontic treatment. In adults the treatment often takes longer than in adolescents and the treatment options are more limited. In adults, jaw corrections are only possible through a jaw operation.
There can also be too large differences in position, shape or in the size of the upper jaw and / or lower jaw in young people. Treatment by the orthodontist alone is not enough. An operation is also needed to restore the function, for example the bite, and sometimes the harmony of the face. When a jaw relation (Angle class II or III) is surgically corrected, we speak of an osteotomy.
Different jaw operations are possible:
- Moving the upper jaw;
- Moving the lower jaw;
- Moving both jaws;
- Moving the chin tip;
- Moving the cheekbone.
It is almost always necessary for orthodontic treatment and straightening of the teeth before the operation. This may mean that the patient must first wear orthodontic equipment for approximately two years to bring the teeth into the correct position.
The jaw operation is performed during the brace period. Orthodontic after-treatment is often required after the operation.
With a jaw displacement of the upper jaw, a Le-Fort-I osteotomy, horizontal bone cuts are made through the nasal cavities and through the nasal septum. The upper jaw is thus detached from the skull and can be put in the correct position. The jaw is fixed with metal wires or plates and screws. Sometimes it is necessary to temporarily fix the upper and lower jaws together with metal wire to obtain a stable result. We call this intermaxillary fixation. The patient will have to use liquid food for a while after the operation and will only be able to eat normally after a while (see image below).
With a jaw displacement of the lower jaw, a sagittal fission osteotomy, vertical bone cuts are made in the corpus mandibulae. The element-bearing part of the jaw can now be moved relative to the ramus mandibulae. The jaw parts are fixed with plates and screws.
Following sagittal fission osteotomy, the sensation of the lip and chin may be reduced for a few weeks to months. The feeling usually recovers, but in some cases the lower lip feels different after a year (see image below).
In addition to the aforementioned osteotomies, a choice can be made to move part of the jaw. This is called a segment osteotomy. An example of this is displacement of the chin tip.