Dysgnathia surgery - specialists and information

What is dysgnathia surgery?

Dysgnathia surgery involves the surgical correction of a malocclusion. Dysgnathia (Greek: dys- = miss-, gnathos = jaw) refers to a disproportion of the jaw and the resulting misalignment of teeth and chin.

Forms of dysgnathia

Depending on how the malformation looks in detail, doctors differentiate between

• Transverse dysgnathia
• Vertical dysgnathia
• Sagittal dysgnathia

In transverse dysgnathia, the upper or lower jaw is too narrow, which often results in misaligned teeth.

In vertical dysgnathia, the upper jaw is too long. This leads to the so-called long face syndrome or gummy smile. The center of the face appears too long and when smiling, more of the teeth and gums are visible than usual or beautiful. If the lips cannot be closed completely, this is more than just an aesthetic problem.

In sagittal dysgnathia, either the upper or lower jaw is too far back. If the upper jaw is affected (progenia), the midface appears flattened, the upper lip is narrow and lies behind the lower lip, the chin appears to protrude. If the lower jaw is affected (prognathism), the typical receding chin occurs.

In the case of facial asymmetry or facial scoliosis, deformations of the bone tissue are responsible for the tip of the nose and chin being displaced from the midline of the face. In practice, a combination of the various malpositions is often present.

Reasons for dysgnathia surgery

Our appearance determines to a large extent how we feel. If we are unhappy, this can have a negative impact on our emotional well-being. If the psychological strain is very strong, then you should take action.

Apart from the psychological stress, dysgnathia also causes physical impairments:

• Difficulty and pain when biting and chewing
• Pain in the jaw joints, neck and head
• Snoring
• Increased susceptibility to infections in the sinuses, throat and upper respiratory tract
• Speech disorders due to the incorrect position of the tongue

From an orthodontic point of view, there is also the misalignment of the teeth, which can lead to problems such as poor oral hygiene and even premature tooth loss.

The aim of dysgnathia surgery is to correct the misalignment of the jaw by means of surgical correction. This improves the functionality of the jaw and the aesthetics of the affected person. Pain and functional problems disappear: Chewing, speaking and breathing through the nose are possible without restrictions.

In progenia ,the lower teeth are positioned in front of the upper teeth. @ Марина Демешко / Adobestock

Procedure of the operation

In most cases, orthodontics, oral surgery and facial surgery will work together to correct dysgnathia.

Jaw impressions and x-rays help to plan the operation in advance. All surgical treatments are performed under general anesthesia and require an inpatient stay of between two and seven days. Incisions are made through the oral cavity and leave no visible scars.

• For mild dysgnathia, the orthodontist can correct the misalignment of the teeth with fixed brackets, removable braces or splints.
• If the upper jaw is too narrow, it is stretched with a fixed appliance. The so-called palatal expansion (GNE) creates space through new bone growth. The expansion phase begins one week after the operation, during which time you will be able to screw on the appliance yourself. Don't worry: this is painless!
• If the lower jaw is too narrow, something similar happens. In the case of a mandibular mid-split (mandibular distraction), the incision is made at the symphysis, in the middle of the chin tip.
• In longface syndrome, the upper jaw is detached through an incision in the oral cavity, shortened and fixed in the correct position with tiny plates.
• In maxillary retraction, an incision through the oral cavity loosens the maxillary bone on both sides. It can then be pushed forward like a drawer and fixed in the correct position with small plates.
• In mandibular repositioning, the lower jaw is separated on both sides through an incision at the level of the wisdom teeth. This allows it to be moved to the correct position and fixed in place with small plates.
• In the case of facial asymmetry, the upper jaw is first detached, moved and fixed in place. The lower jaw is then detached, adjusted in position and fixed.

After the operation

You will still be able to speak, drink and eat after the operation. At first, you will only eat liquid food. After the first few days, you can switch to soft foods such as pasta dishes. After 6 weeks you can switch to normal food. During this time, you should also refrain from smoking and physical exertion. Brushing your teeth is also important during the healing process!

Risk and prognosis of dysgnathia surgery

Serious complications are extremely rare during surgery. Risks such as damage to nerves and tooth roots as well as discomfort in the temporomandibular joints or even malpositioning rarely occur. If problems do occur, they are usually easy to treat.

Normal side effects are Swelling, bruising, bloody discharge from the nose and restricted mouth opening. These usually soon subside with consistent cooling, lymph drainage and physiotherapy. You must not blow your nose for the first 14 days.

Conclusion

Surgical treatment of dysgnathia is not always necessary. If it is, it is a low-risk procedure thanks to modern technology and the collaboration of specialists from various fields.

You should expect to stay in hospital for a maximum of one week. After about 6 weeks, you will be over the process. If indicated, the costs are covered by health insurance.