Orthodontic Preparation for Surgery

Preparing the Teeth and Bite Alignment 

Orthodontic preparation for surgery is an important part of the process as far as different dental and facial surgeries are concerned. They follow a very detailed procedure of positioning the teeth and the bite, which not only adds to the aesthetic results but greatly impacts the functional aspect of the surgery. Before or after orthognathic (jaw) surgery, cleft palate surgery, or any other corrective procedure, orthodontics cannot be underestimated.  

The Role of Orthodontics in Surgical Preparation  

Orthodontics is a vital partner in the success of surgeries conducted on jaws and teeth. Orthognathic surgery is most effective after orthodontic treatment as it prepares the patient’s teeth and bites for surgery. Here are some key ways orthodontics contributes to surgical success: 

• Improved Surgical Access and Precision: Correct positioning of the teeth and jaws gives the surgeons a clear and easy view of the area to be operated on, hence performing the operation more effectively. This can result in shorter operating times and reduce the risks associated with the surgery.  
• Optimal Jaw Alignment: Orthodontics assist in correcting the position of jaws which is important in surgeries like orthognathic surgery. Correct positioning helps in the proper functioning of the jaw after the surgery has been done.  
• Enhanced Aesthetic Outcomes: Orthodontics, in preparation for surgery, corrects dental alignment and bite problems to improve facial proportions and the balance of the smile, thereby improving the aesthetic outcome of the surgery.  

• Stabilization and Healing: Properly aligned teeth and jaws provide better surgical outcomes and, additionally, the stability of the structures. This can lead to shorter time to heal, and largely anticipated outcomes.  

Thus, the cooperation of orthodontists and surgeons allows the development of a treatment plan that meets not only the dental and skeletal requirements of the patient but also guarantees the success of the surgery and the improved appearance of a smile. 

Initial Consultation and Assessment  

What to Expect During the First Visit  

The first consultation can be considered as one of the most important stages of orthodontic preparation for surgery. During this visit, you can expect the following: 

• Medical and Dental History Review: First, the orthodontist will ask about your past and present health and your past and present dental care. This entails disclosing any previous treatment, surgery, or any other active health complications that may affect your orthodontic and surgical treatment plan.  
• Comprehensive Oral Examination: A detailed checkup of your teeth, gums, and jaws will be done. This enables the orthodontist to have an initial look at your current dental status and all the problems that need to be solved.  
• Diagnostic Imaging: Radiographic films such as X-rays, photographs, and possibly 3D scans will be done to give details of your dental and skeletal structures. These images are very important in the creation of an appropriate therapy regimen.  
• Dental Impressions: Records such as impressions of the teeth may be made to assist the orthodontist in understanding the bite and how the teeth fit. These models are used for the designing of the exact movements that need to be made during the treatment.  
• Discussion of Concerns and Goals: This will be the chance to voice out your worries, expectations, and what you wish to achieve with the orthodontist. This distinction is beneficial in aligning the treatment goals with the patient’s expectations, as it may focus on function, appearance, or a combination of both.  

Diagnostic tools and techniques used  

Several diagnostic tools and techniques are employed during the initial consultation and assessment to ensure a comprehensive evaluation:  

• Panoramic X-rays: These give an overall perspective of the total mouth area, such as the teeth, upper and lower jowls, and other areas. It helps locate affected teeth, deviations from the norm in the structure of the jaw, and other problems.  

• Cephalometric X-rays: These are the side-view X-rays of the head and jaw which are crucial for studying the interconnection of the teeth, jaws, and the face. They assist in the planning of surgical and orthodontic operations.  
• Cone Beam Computed Tomography (CBCT): This is a technique that offers tomographic images of the teeth, jaws, and other related structures. It provides fine information, which is more important when dealing with highly charged cases.  
• Digital Impressions: Today, orthodontic appliances can employ digital scanners that can capture accurate 3D images of the teeth and the bite. These models are more accurate and comfortable for the patients as compared to the traditional impression materials.  
• Photographic Records: X-rays and photographs of the face and the teeth are also taken to establish the present position and for comparison with the progress of the treatment. They are also used in case presentation and planning for the treatment of the patient.  

Customized Treatment Plan  

The treatment plan will be drawn from the results of the first consultation and diagnostic tests and procedures. This plan outlines the steps needed to prepare your teeth and jaws for surgery, including: 

• Detailed Treatment Timeline: A timeline will be set for the orthodontic treatment phase, the date for surgery, and the post-surgical orthodontic phase.  
• Selection of Orthodontic Appliances: Based on the presented case and the goals of the treatment, the proper orthodontic appliances to be used (braces or aligners) will be determined.  
• Specific Treatment Goals: For each phase of the treatment, realistic objectives that should be accomplished will be established so that all the functional and esthetic dental and skeletal requirements are met.  

The initial consultation and assessment are crucial for laying the foundation of a successful orthodontic and surgical journey. By thoroughly evaluating your dental health and discussing your goals, the orthodontist can create a tailored plan that ensures optimal results and a smooth treatment experience. 

Orthodontic Appliances and Techniques Used  

Braces  

• Traditional Metal Braces: Ordinary metal braces are made of metal brackets and wires. They are very efficient when it comes to remedial action on many dental complications and abnormalities such as extreme misalignment and improper bite.  
• Ceramic Braces: These braces work like ordinary metal braces but the brackets are either tooth-colored or clear ceramic. Lithium is used as a preferred option for patients who wish to have a better appearance.  
• Lingual Braces: These braces are fixed on the back of the teeth, which is the lingual side, such that they are not visible from the exterior. They are designed specifically for every patient and are ideal for managing complicated conditions secretly.  
• Self-Ligating Braces: These braces come with a sliding mechanism instead of the elastic ties that are used to hold the wire in place. This may cut some of the friction, ease shifts in treatment plans, and possibly shorten the duration of the treatment.  

Clear Aligners  

• Invisalign: Invisalign aligners are clear and plastic, removable, and made to fit the teeth of the patient. They are a perfect choice for all individuals who want to treat their dental issues with the help of orthodontic appliances that are almost invisible to others. Some aligners are to be worn for two weeks before they are changed since they gradually move the teeth to the required position.  

Other Orthodontic Appliances  

• Palatal Expanders: These devices are applied to expand the arch of the upper jaw to provide enough space for correct teeth positioning. Palatal expanders are commonly applied to patients with growing jaws, which are usually children.  
• Retainers: It is worn after the braces or aligners have been removed to hold the teeth in their new position. Retainers can be of two kinds: removable and fixed (or bonded), and the choice depends on the dental condition of the patient.  
• Headgear: Headgear is a dental appliance worn outside the mouth partly and used to deal with severe bite issues by regulating the jaw development and the position of the teeth. It is typically used for a certain number of hours daily and is removed at night.  

By understanding the role of each appliance and technique, patients can feel more informed and confident about their orthodontic and surgical journey. This knowledge also highlights the importance of collaboration between orthodontists and surgeons in achieving optimal results. 

Contact your Pinole dentist, Dr. Hoss Abar, DDS, MSD at Abar Orthodontics, to learn more about Orthodontic Preparation for Surgery.

Resource:

Prognathism: Corrective jaw surgery for protruding jaws.

*This media/content or any other on this website does not prescribe, recommend, or prevent any treatment or procedure. Therefore, we highly suggest that you get the advice of a qualified dentist or other medical practitioners regarding your specific dental condition.*