Case Studies

Orthognathic Surgery

Dr Firdaus Hanapiah
BDS(Otago) MSc(Lon.) FDSRCS(Eng.)

Before Surgery

Orthognathic surgery is an option for patient who has major facial discrepancies in terms of both dental and skeletal relationships. It is a relatively common problem. The surgery will help both aesthetically as well as improvement in functionality such as occlusion, mastication and speech. The pictures and illustrations below describe a case report of surgery involving both the maxilla as well as the mandible.

A twenty-year-old man was referred by his dentist to the Oral and Maxillofacial Department University of Malaya, Kuala Lumpur, Malaysia. He dislikes his large jaw and wants something done to it. It was decided that some decompensating orthodontic treatment would be done and after that, a bimaxillary osteotomy is planned and carried out.

Picture above shows occlusion before surgery

After surgery

After eleven months of orthodontics, the patient underwent a bimaxillary surgical procedure in which the lower jaw was pushed back by 6mm via a sagittal split osteotomy and the maxilla was pushed forward by 3 mm via a Le fort I osteotomy. The picture below shows the patient six months after the operation. Note that the profile has much improved and the occlusion was restored to a Class I skeletal as well as dental relationships.