What is surgical orthodontics?

 

Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient´s ability to chew, speak, and breathe and for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps make sure teeth are in their proper positions after surgery.

Who needs surgical orthodontics?

Your orthodontist will consider surgical orthodontic treatment for non-growing adult patients with improper bites and those with facial aesthetic concerns. Jaw growth is usually completed by age 16 for girls and 18 for boys.

surgical ortho diagram

How does it work?

During your orthodontic treatment, which usually lasts 6-18 months, you wear braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.

Surgery is performed in the hospital with an oral surgeon, and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised, lowered and even widened. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.

When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4-8 weeks), your orthodontist “fine-tunes” your bite. In most cases, braces are removed within 6 following surgery. After your braces are removed, you will wear a retainer at night to maintain your beautiful new smile.

 

Temporomandibular Disorder (TMJ)

Millions of Americans suffer from chronic facial and neck pain as well as recurrent headaches. In some cases this pain is due to Temporomandibular Disorder, or TMD.

Your temporomandibular joints, or jaw joints, connect your lower jawbone to your skull. As you may imagine, these joints get quite a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.

Symptoms of TMD include:

  • Pain in the jaw area
  • Pain, ringing, or stuffiness in the ears
  • Frequent headaches or neck aches
  • Clicking or popping sound when the jaw moves
  • Swelling on the sides of the face
  • Muscle spasms in the jaw area
  • A change in the alignment of top and bottom teeth
  • Locked jaw or limited opening of the mouth
  • Excessive clenching and grinding of teeth

Should you notice any of these symptoms, let us know! We can help advise you as to whether they indicate the presence of TMD, and what sort of treatment is appropriate for you.

If you don’t have any of these symptoms, let’s keep it that way! There are some simple things you can do at home or work to prevent TMD from occurring in your jaw joints:

  • Relax your face – remember the rule: “Lips together, teeth apart”
  • Avoid grinding your teeth
  • Avoid constant gum chewing
  • Don’t cradle the phone receiver between your head and shoulder – either use a headset or hold the receiver to your ear
  • Chew food evenly on both sides of your mouth
  • Do not sit with your chin rested on your hand
  • Practice good posture – keep your head up, back straight, and shoulders squared
  • Try not to clench your teeth. Keep them apart and relax your jaw.

TMJ problems are generally classified into two basic categories: Muscular Problems and Internal Joint Damage.

Muscular Problems

Muscular problems are reversible because there has been no damage inside the joint itself. The chewing muscles are in spasm due to a poor bite forcing the lower jaw out of position on closure. This muscle tension is manifested as headaches, grinding of the teeth, ringing in the ears, or neck and shoulder pain. Because stress causes many people to clench their teeth, nervous tension can worsen these problems. Such problems are easily corrected by relaxing the muscles and ultimately correcting the bite problem. A bite splint can be used to separate the bite and relax the muscles. This can be followed with orthodontic treatment to ultimately correct the bite.

Internal Joint Damage

Internal joint damage is when damage has actually occurred inside the joint. Such problems are not as reversible as muscular problems. The following illustration depicts the NORMAL joint function:

tmj 1

The following illustration depicts DISK DISPLACEMENT. Often due to jaw misalignment, the ligaments are compressed and stretched, causing them to degenerate from the pressure of the jaw pushing up on them as the jaw moves. Adjacent nerves and blood vessels are compressed, causing pain and headaches.

tmj 2

In the most severe cases, the back ligaments degenerate away completely. The patient now has bone-to-bone contact and the bone wears down and becomes arthritic. Joint function becomes further limited and the patient is able to open less and less.

tmj 3

Dentofacial Orthopedics

 

You may have noticed that we specialize in “Orthodontics and Dentofacial Orthopedics.” While most people have heard of orthodontics, many are confused by the “dentofacial orthopedics” part of the title. We can explain!

Every orthodontist starts out in dental school. Upon completion of dental school, some graduates immediately go into practice as dentists. Others choose to pursue a dental specialty, which requires additional schooling during a two- to three-year residency program. There are nine specialties sanctioned by the American Dental Association. Some you are likely familiar with are Pediatric Dentistry (dentistry for children), Periodontics (dentistry focusing on the gums), and Oral Surgery.

One of the nine specialties is Orthodontics and Dentofacial Orthopedics. You probably know that an orthodontist straightens teeth, and indeed: “ortho” comes from the Greek for “straight” or “correct,” and “dontic” from the Greek for “teeth.” But what about dentofacial orthopedics? “Dentofacial” is “teeth” plus “face” while “ortho” again means “straight” and “pedic” is from the Greek for “child.”

Essentially, while orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. In both cases, appliances are frequently used – the more familiar braces for orthodontics, and other specialized appliances like expanders, etc. depending on what facial abnormalities are present. Sometimes orthopedic treatment may precede conventional braces, but more often, with Dr. Iacobelli’s effeicient techniques, the two are accomplished at the same time. So if your child gets braces, many times, he or she is undergoing orthodontics and dentofacial orthopedics!

Because our doctors are specialists, they are skilled in both areas and are able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise an holisitc treatment plan that simultaneously integrates both orthodontic and dentofacial orthopedic treatments.

Invisalign

We are a Certified and “Preferred” Invisalign® Provider

Consider Invisalign to get the beautiful straight teeth you’ve always wanted — without braces. A complimentary examination with Dr. Iacobelli can determine if Invisalign is right for you.

invisalign

What is it?

Invisalign uses a series of invisible, removable, and comfortable aligners that no one can tell you’re wearing. So, you can smile more during treatment as well as after. Invisalign is made with 3-D computer imaging technology and has been proven effective. More than 70% of orthodontists in the U.S. and Canada are certified to treat with Invisalign. Due to the hight volume of cases we performed, we have earned the “preferred provider” status.

Why would I want it?

Not only are the aligners invisible, they are removable, so you can eat and drink what you want while in treatment. Plus, brushing and flossing are no problem. They are also comfortable, with no metal to cause mouth abrasions during treatment. And no metal and wires usually means you spend less time in your doctor’s office getting adjustments. Invisalign also allows you to view your own virtual treatment plan when you start so you can see how your straight teeth will look when your treatment is complete.

How does it work?

You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss. As you replace each aligner with the next in the series, your teeth will move — little by little, week by week — until they have straightened to the final position our doctors have prescribed. You’ll visit our practice about once every 4 weeks to ensure that your treatment is progressing as planned. Total treatment time averages 9-12 months and the average number of aligners worn during treatment is 18, but this will vary from case to case.

Dr. Iacobelli is a Certified Invisalign Teen™ Preferred Provider

 

Bummed out about having braces? Invisalign Teen gives you a whole new way to wear braces for a “clearly” amazing smile!

I have enough to worry about…
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    Unlike traditional metal braces, your Invisalign Teen aligners are removable, which means you can go ahead and eat all the things you love without worrying about breaking a bracket or losing a rubber band. Cheers!

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  • Request your Invisalign Teen Information Kit!

    Get a FREE Information Kit from Invisalign. Or, email Dr. Iacobelli today for a FREE examination! What do you have to lose?