New Techniques for Orthognathic Surgery

Biocompatible mini-devices that replace the need for open surgery and bone-cutting techniques that drastically reduce the length of orthodontic treatment were presented at a symposium on minimally invasive orthognathic surgery at the annual meeting of the American Association of Oral and Maxillofacial Surgeons (AAOMS) in Boston (MA, USA) in September 2005.

Orthognathic surgery repositions, widens, and/or narrows upper or lower jaws in order to improve function and appearance. As orthognatic specialists, oral and maxillofacial surgeons (OMS) often work with orthodontists to achieve results that braces alone cannot accomplish. Now, the development of minimally invasive techniques is saving patients from the discomfort and expense of longer, more elaborate operations and hospitalizations.

A traditional orthognathic procedure known as a maxillary osteotomy is performed under general anesthesia in a hospital operating room to raise the upper jaw in the back of the mouth in order to close the bite in front. Through a minimally invasive technique, the OMS surgically places titanium miniplates in the cheekbone, where they function as skeletal anchors that move the molars in the back of the mouth up, facilitating bite closure.

Another technique, known as selective alveolar decortication, can reduce the length of orthodontic treatment in adult patients by 60-70%. Still another technique, distraction osteogenesis, offers OMS a less invasive method for remedying severe facial skeletal deformities, including cleft palate. The OMS makes a gradual, controlled series of small, surgically created fractures to "stretch” the body into forming new bone and can even be used to extend bone between specific teeth.

"All these developments share the goal of taking a more involved surgical procedure and making it simpler--transitioning a procedure that was traditionally done in the hospital under general anesthesia to an outpatient or office-based procedure using local anesthesia,” said symposium moderator Joseph E. Van Sickels, D.D.S., director of the oral and maxillofacial residency program at the University of Kentucky (Lexington, KY, USA)




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