ORTHOGNATHIC (JAW) SURGERY
Orthognathic surgery is the treatment of facial, airway and bite discrepancies by moving the jaws (gnathic) into the correct (ortho) position for proper esthetics and function.
Orthognathic surgery can involve the upper jaw or maxilla (LeFort osteotomy) and/or the lower jaw or mandible (bilateral sagittal split osteotomies).
—Dr. Michael Gunson
Case Study: Esthetic Treatment Planning
A. 21-year-old male patient with rheumatoid arthritis - showing lack of mandibular projection, width, and definition. Joint disease was controlled with condyle-sparing medications, including Enbrel tumor necrosis factor alpha inhibitor.
B. Seven-step cephalometric treatment plan (CTP) - showing surgical movements needed to correct face, airway, and bite (FAB). Significant bimaxillary counterclockwise advancements were required: ANS, 0mm; maxillary incisor tip, 9.5mm; mandibular incisor tip, 9.4mm; pogonion, 23.6mm.
C. Three and a half years after bimaxillary counterclockwise advancement surgery - note definition of mandibular position in all planes of space. Occlusion was intentionally left Class III at surgery as overcorrection. On Enbrel and other medications, occlusion has remained stable.