In individuals, the upper and/or lower jaw may be recessed, protruded, narrow, or elongated. If the patient is a child still undergoing growth and development, growth-guiding treatments can be applied. Therefore, children should be examined by an orthodontist no later than age 8.
For patients who have completed their growth and development, it is not possible to move the jawbones without surgical intervention, and orthognathic surgery is required to correct jaw discrepancies.
Face Mask Therapy:
This treatment is used for cases of maxillary deficiency (underdeveloped upper jaw). It is suitable for children whose cheekbones are not prominent and whose lower teeth are positioned in front of the upper teeth. The treatment involves placing a fixed appliance inside the mouth that cannot be removed, which aids in correcting the jaw alignment.
Hooks on this appliance are connected to an external face mask. The patient must wear this face mask for 16 hours a day and attend regular check-ups to ensure the treatment’s success. Otherwise, the treatment is likely to fail. The ideal age for this treatment is between 8 and 10 years. At older ages, the success rate of the treatment decreases significantly because the upper jawbone fuses with other bones.
Activator Treatment (Monoblock, Twin Block):
These appliances are used to treat lower jaw deficiencies. If the patient has a significantly recessed lower jaw, experiences breathing difficulties, and their upper teeth are far ahead of their lower teeth, parents should have their child examined by an orthodontist. This treatment involves creating a removable appliance based on the patient’s dental impressions. The patient should use this appliance around the age of 12, during the most active period of growth and development. The appliance must be worn for at least 20-22 hours a day. Failure to comply with these usage requirements often results in unsuccessful treatment, necessitating surgical intervention after the age of 18.
Orthognathic Surgery:
Orthognathic surgery is a treatment option for patients who have completed their skeletal development and exhibit misalignment between the upper and/or lower jaws. This is a multidisciplinary treatment involving both an orthodontist and an oral and maxillofacial surgeon. Therefore, patients are advised to evaluate the entire treatment team comprehensively before proceeding.
Treatment Process
Before orthognathic surgery, the orthodontist applies braces for a period determined by the complexity of the case. This ensures that the teeth are aligned and leveled to allow for proper jaw movement during surgery. Additionally, the orthodontist plans the extent of jaw movement required and provides the surgeon with surgical splints reflecting this plan.
The patient undergoes surgery while wearing braces. Post-surgery, the upper and lower jaws are repositioned and secured together using elastic bands and the surgical splints. The patient continues to wear the splints and elastics for approximately two weeks after the surgery.
After the splints are removed, orthodontic treatment continues for a while to adjust the teeth to their ideal positions relative to the jaws. Once the treatment is complete, retainers, such as protective wires attached behind the teeth and clear protective aligners, are provided to maintain the results.
