Severe malocclusions frequently require combined orthodontic and surgical treatment to achieve optimal and stable results. Successful therapy requires understanding and cooperation between orthodontist and maxillofacial surgeon, each contributing to a correct diagnosis and appropriate treatment plan. Orthodontist's influence is largely limited to tooth movement and alveolar bone with a very little effect on basal bone. Maxillofacial surgeon could produce facial skeleton movement but can not provide proper alignment of teeth. Thus, maxillofacial surgeon repositions the jaw and facial structures in the correct position according to the present anomaly of therapeutic targets, and orthodontist align the teeth properly jaws. The role of orthodontic-surgical team is to make a diagnosis of existing anomalies, to develop an appropriate treatment plan and properly execute the recommended treatment.
Three fundamental goals of surgery in treatment are: functionality, esthetics and stability. These three objectives are the primary goals in treating patients with malocclusions.
Generally, the sequence phase of surgical-orthodontic treatment is the following:
1. Pre-operative orthodontic phase (9-18 months). Teeth are aligned in the
optimal position for each dental arch.
2. Surgery and during recovery phase (4-6 weeks). The surgeon intraoperatively
positioned jaws are interconnected most favorable for obtaining a correct bite
and some facial proportions balanced.
3. Post-operative orthodontic phase to complete occlusion. This process
occurs after the healing period and involves minor tooth movement to obtain a
4. Retention phase - after completion of orthodontic treatment retention devices
are applied to stabilize teeth in their new position.
Smile Center doctors have experience in solving many difficult orthodontic-surgical cases.
Example below the result of our collaboration with Dr. Eduard Paraschivescu (MD Oro-Maxillofacial Surgery).