Orthognathic Surgery in Singapore

Corrective jaw surgery, while significantly transforming facial aesthetics, primarily extends beyond mere cosmetic enhancement.

Orthognathic surgery is a specialised form of surgery aimed at correcting conditions of the jaw and face that impact both function and appearance of the mouth. It is also commonly known as corrective jaw surgery or jaw alignment surgery. Read on to discover more details about the preparation for orthognathic surgery, the surgical process itself, and what you can expect during recovery.

Jaw abnormalities are identified through a thorough clinical examination process initiated by your healthcare provider. This typically involves evaluating your detailed medical history and conducting a comprehensive physical examination.

Diagnostic Tests Include:

• X-rays: To inspect bone structure and position of jaws and teeth.
• CT Scans: Provide a more detailed three-dimensional view of the jaw.
• MRI Scans: Useful for viewing soft tissues and joint functionality.

Dental professionals may also employ:

• Dental Models: These are impressions taken to meticulously assess your bite and how your teeth come together (occlusion).
• Photographs and Video Recordings: These are taken to capture your facial aesthetics and movements for further analysis.

For certain conditions, such as suspected sleep apnea, a sleep study or polysomnography might be recommended.

After the initial assessments, the oral and maxillofacial surgeon will collaborate closely with your orthodontist to discuss the findings and develop a tailored treatment plan. This multidisciplinary approach ensures that all aspects of your jaw’s health are considered to optimise the results of any potential interventions.

Jaw abnormalities, often leading to facial deformities, can arise from various causes stemming from congenital factors or acquired conditions throughout life. These deformities might include misaligned jaws, disproportionate facial structure, or other irregularities that impact both aesthetics and function.

Understanding these various factors contributing to jaw abnormalities is essential for diagnosis and selection of appropriate orthognathic treatment options.

Orthognathic surgery addresses breathing problems like Obstructive Sleep Apnea (OSA) by realigning the jaw to widen the airway. It also addresses issues like chronic mouth breathing, nasal airway obstruction and snoring.

Orthognathic surgery corrects jaw misalignments in individuals with cleft lip and palate, improving bite function, facial symmetry, and speech. It addresses skeletal discrepancies, aiding in the comprehensive rehabilitation of cleft-related deformities for enhanced oral health and aesthetic outcomes.

An overbite involves the upper jaw extending far over the lower jaw, leading to excessive coverage of lower teeth by upper teeth and potential complications.

An underbite, often a result of a protruding lower jaw, is characterised by the lower jaw extending beyond the upper jaw. This affects facial appearance, chewing, and speaking abilities. Orthognathic surgery can correct this by realigning the lower jaw to a more balanced position.

In an open bite, a gap remains between the upper and lower teeth when the mouth is closed, hindering proper chewing and potentially causing speech issues.

Crossbite occurs when upper and lower teeth misalign, causing uneven teeth wear and chewing difficulties.

Orthognathic surgery addresses facial imbalances like asymmetry (one side of the face differing from the other), uneven jaw, and disproportion (mismatched jaw and face sizes). This includes conditions where one side of the jaw is longer or shorter, leading to challenges in function and aesthetic appearance.

Corrective surgery can alleviate symptoms like pain, clicking, and jaw locking associated with temporomandibular joint disorders.

A smile which occurs when a significant amount of gum is visible above the top teeth when you smile, affecting appearance and oral health.

This condition can hinder oral hygiene and raise periodontal disease risk. A gummy smile may indicate misaligned teeth or jaws, leading to bite issues, chewing difficulties, and uneven tooth wear. These can worsen oral health problems like tooth decay, gum disease, and TMJ disorders.

Orthognathic surgery can fix it by reshaping gums, teeth, or jaws.

Maxillary osteotomy, a type of surgical procedure, involves cutting and repositioning your upper jaw, known as the maxilla. This is done to correct alignment issues and improve the relationship between your upper and lower jaw, which can impact both function and facial aesthetics.

Conditions Treated:

• Open Bite: A condition where your upper and lower teeth don’t meet when your mouth is closed.
• Crossbite: When upper teeth bite inside the lower teeth.
• Vertical Height Abnormalities: Corrects both excessive and insufficient heights of the upper jaw.
• Midface Deficiency or Excess: Adjustment to the forward or backward positioning of the midface.
• Nasal Airway Obstruction: Addressing blockages or deformities that affect nasal breathing.

Procedure Steps:

• Incisions: Your surgeon will make incisions inside your mouth, above the upper teeth.
• Cutting and Repositioning: The maxilla will be divided into segments before being moved into the corrected position.
• Fixation: The new position of the jaw segments will be secured using plates and screws.
• Stitching: The incisions will be closed with stitches.

This procedure can lead to significant improvements in how your teeth meet and in your overall facial balance, providing aesthetic enhancements like the correction of a ‘gummy smile’.

Genioplasty, commonly known as chin surgery, is a surgical procedure aimed at enhancing your facial aesthetics by altering the shape or position of your chin. This surgery addresses several chin-related concerns that can affect your facial proportion, such as a protruding or receding chin, asymmetry, abnormalities in size, or deformities arising from trauma or disease.

Indications:

• Protruding or receding chin
• Asymmetrical chin shape
• Undersized or oversized chin
• Chin irregularities due to trauma or illness

Surgical Procedure:

1. An incision is made inside your mouth, near the lower lip, to access the chin bone.
2. The chin bone is cut and repositioned – it can be moved forward, back, up, down, or sideways, depending on your needs.
3. The repositioned bone is then secured with plates and screws.
4. After the bone is fixed in place, the incision is closed with stitches.

• Initial Consultation and Diagnosis: You meet with an orthodontist to discuss concerns. A thorough examination, including X-rays and dental models, establishes if orthognathic surgery is necessary.
• Treatment Planning: A custom treatment plan is developed. This often involves the use of 3D imaging to visualise the end results and to plan the surgical movements of the jaw bones.

• Pre-Surgical Orthodontics: Braces are applied months before surgery to move your teeth into the correct position for the procedure. This phase can last 6-18 months, depending on individual needs, and includes regular adjustments.

• Orthognathic Surgery: Performed under general anaesthesia, the surgeon makes precise incisions and bone cuts. Jaws are repositioned, and stability is achieved using screws and plates.
• Immediate Post-Surgical: You’ll recover in hospital for a short period. Swelling and discomfort are managed with medication.

• Post-Surgical Orthodontics: Following surgery, braces remain in place to fine-tune tooth alignment. This typically lasts for 6-12 months.
• Ice Packs: Using ice packs during the initial recovery phase helps reduce swelling and alleviate pain, contributing to a more comfortable healing process and supporting the effectiveness of ongoing orthodontic adjustments.
• Final Adjustments & Retainers: After removing your braces, retainers maintain the new position of your teeth. Use of rubber bands may be advised for maintaining bite alignment.

• Improved function: Post-surgery, you’re likely to experience more efficient chewing, swallowing, and speech. This is due to the realignment of jaws improving occlusion—the way upper and lower teeth come together—which plays a crucial role in these everyday activities.
• Aesthetic improvement: The surgery not only aims to correct functional issues but also to improve facial appearance significantly. This includes achieving a more balanced and symmetrical facial structure, enhancing the overall aesthetic appeal.
• Dental health: It also potentially lessens the likelihood of dental problems and infections, as the teeth are more likely to be properly aligned and easier to clean, reducing places for bacteria to hide.
• Self-confidence: A positive change in your look often correlates with an increase in self-esteem. A more aesthetic facial appearance can make you feel more confident in social situations.
• Breathing and sleep: Addressing structural issues through surgery can enhance breathing and mitigate conditions like sleep apnea, leading to better sleep quality and overall health.

Orthognathic surgery offers notable enhancements to both functional and aesthetic aspects of your oral and facial structure.

Alternatives to Surgery

• Orthodontic Treatment: Your orthodontist might use braces, aligners, or retainers to correct misalignments. This non-surgical approach focuses on moving your teeth and jaw into better positions over time.
• Oral Appliances: Devices like mouthguards, splints, or night guards can protect your teeth and jaws. These are particularly useful to prevent damage or to alleviate stress-related symptoms.
• Functional orthodontic appliances: Functional orthodontic appliances are specialised devices designed to correct bite issues and align the jaw properly during the growth phase. These appliances are most effective in children and teenagers, as they leverage the growth spurts to guide the development of the jaws and teeth into more favourable positions.

It is essential to consult with both your oral and maxillofacial surgeon and your orthodontist. They are equipped to assess the severity of your condition and to guide you towards the most appropriate course of action. Remember, the efficacy of these alternative treatments can vary, so professional advice is crucial to making an informed decision.

In some instances, particularly when your jaw problems are mild to moderate, surgery may not be necessary. Alternative treatments can often yield suitable outcomes for most patients, avoiding the need for invasive procedures.

Your health insurance may cover a part of the surgery if it’s deemed medically necessary: check with your provider on eligibility and extent of coverage (if applicable).

Medisave allows up to $5,000 annually with a $450 daily limit for surgery, and up to $300 daily for related consultations and medications. Medishield Life covers 80% of subsidised hospital bills but involves a deductible and co-payment. The Community Health Assist Scheme (CHAS) offers subsidies for orthodontic treatments and related services, with amounts varying based on income. For those still struggling financially, MediFund acts as a safety net following a means test and medical assessment.

At Nuffield Jaw Surgery, our team of oral and maxillofacial surgeons brings a wealth of experience to the table. Each surgeon is professionally qualified and deeply committed to delivering patient-focused care. Our approach is rooted in understanding each patient’s unique needs and providing care that aligns with those requirements.

In line with modern surgical practices, we utilise advanced technology such as 3D imaging and computer-aided design. These tools assist in enhancing the precision and safety of our surgical procedures.

Regarding financial aspects, we believe in transparency. Our team is available to provide clear information about the costs involved in jaw surgery and to guide you through understanding the available subsidies and financial aid options in Singapore.

For those interested in exploring jaw surgery options or seeking more information about our services, we welcome you to reach out to us. At Nuffield Jaw Surgery, we are dedicated to being a reliable healthcare provider in the field of jaw surgery in Singapore.