There are instances where the cause of a particular malocclusion (for example a severe underbite) will be due largely to a mismatch between the upper- and lower jaws. Depending on the severity of the jaw discrepancy and stage of jaw growth, surgical orthodontics, also known as orthognathic surgery, may be required where orthodontic treatment alone cannot produce a satisfactory outcome.
Surgical orthodontics is a combined step-by-step approach where the braces align and reposition the teeth while jaw surgery manipulates the jaws into their ideal position. This not only creates the position for the teeth, chin position and facial profile, but also improves the patient’s ability to chew, speak and breathe.
Surgical Orthodontics demands a multidisciplinary approach. If you are a suitable candidate for surgical orthodontics, Dr Skilton and Dr Yap will work in conjunction with a Maxillofacial Surgeon to formulate a combined orthodontic-surgical treatment plan for you.
The initial consultation is an appointment designed to provide you with information and treatment options. At this initial appointment, the general process of a combined orthodontic/surgical treatment will be outlined as well as the advantages and disadvantages of the different treatment options. All orthodontic concerns will be discussed using initial photographs which are taken prior to the visit. The general treatment plan will be illustrated using informative videos so you may have a good understanding of what surgical treatment entails. At the conclusion of the initial consultation, the costs of the orthodontic component of the treatment will be provided and explained with the various payment options.
Due to the need for precision with surgical treatment planning, records are taken prior to a treatment plan being finalised. These records include study models, radiographs and detailed photographs. Your orthodontist will use these records to formulate a very detailed and precise treatment plan to submit to the surgeon. Occasionally you may elect to have another appointment with the orthodontist, to discuss the treatment plan in more detail.
Prior to deciding on a surgical treatment plan, we recommend you have an initial appointment with the maxillofacial surgeon. During this appointment, the surgeon will explain the process of the surgery as well as outline all risks and benefits involved with having the surgery. This is an opportunity to ask any questions you may have pertaining to the surgical treatment.
Once you are happy to proceed with treatment, the next orthodontic appointment is to have your braces fitted. This appointment, also known as the “band-up” appointment as one of two longer appointments of your treatment and is usually scheduled in the middle part of the day. It is a relaxing appointment and no anaesthesia is required to the braces to be fitted. An oral hygiene care session follows the band-up procedure where you will be shown how to care for your teeth and your new braces.
Every 6 to 8 weeks, patients return to the practice for their braces check appointments. At these appointments adjustments may be made to your braces and your progress will be discussed.
Usually after 12 to 18 months, the braces have positioned the teeth in their ideal positions, prior to surgery. Once your orthodontist has made his final checks, he will refer you back to the maxillofacial surgeon for an assessment in readiness for the surgery. The surgeon will schedule a pre-surgical appointment to discuss with you the final aspects of the surgery and answer any questions that you may have. The surgeon will then schedule a surgery date.
The surgery is undertaken in a hospital environment under the strictest of sterile conditions. Depending on the type of surgery you are having, the length of time the surgery will take and the recovery period will vary. The surgeon will discuss all these aspects at the initial consultation, prior to you commencing treatment.
The orthodontic braces remain on your teeth during and after the surgery. After the surgery, you will usually have a remaining 6 to 9 months of treatment to finalise the bite and undertake any detailing.
The procedure of removing braces is a relatively quick and simple one. Once the braces are removed, our hygienists will also clean and polish the bonding resins off the tooth surfaces. A set of impressions is then taken to facilitate the new set of retainers. These appointments usually take place in the morning and you will return in the afternoon for your retainer-fit appointment.
Your retainers retain your new tooth positions and wearing them is paramount to maintaining your new smile. Relapse can occur if retainers are not worn and its severity can present with varying degrees. Further retainer check appointments are included in your initial treatment fee and Dr Skilton and Dr Yap are always happy to provide additional retainer checks if required.
“Camouflage” is a general term which refers to the utilisation of orthodontic braces and other treatment modalities to move teeth into positions to mask an underlying skeletal discrepancy. Many people display varying degrees of jaw discrepancies where either the upper or lower jaws are bigger or smaller than the other. Camouflage is very common and orthodontic practice and usually provides excellent results without the surgery component to treatment.
An orthodontic/surgical treatment will often take in the vicinity of 2 ½ years, depending on the complexity of the malocclusion that has been corrected. An estimated time in treatment will be given at your initial consultation by your Orthodontist.
The costs associated with surgical orthodontics will vary, depending on the severity of the presenting malocclusion and the work required. There are usually two components to the costs of surgical orthodontics, the first being the orthodontic treatment which will be quoted at your initial orthodontic appointment and the second being the surgical component which will be quoted by your maxillofacial surgeon at his/her initial consultation. The surgeon will likely recommend that you are covered by the highest health insurance hospital cover to help with the costs of the surgery, the hospital and the anaesthetist.
All costs will be outlined prior to commencing treatment so there are no unexpected “surprise” costs during or after your surgical orthodontic treatment. It will be very important however that adequate hospital insurance cover is undertaken and that you have exceeded the minimum waiting period for this to be valid, prior to having the surgery. Unfortunately, if sufficient insurance is not obtained, this may mean a delay in the surgical process or significant costs at time of the surgery.