Beverly Hills Corrective Jaw Surgery - Joseph A. Broujerdi, MD, DMD - Oral Surgeon
Dr. Joseph Broujerdi of Cranio-Maxillofacial Surgery Institute in Beverly Hills is a board certified Oral and Maxillofacial Surgeon. If you are experiencing jaw pain, TMJ (Temporomandibular Joint Syndrome), or have a facial injury or birth defect that has affected your jaw alignment, corrective jaw surgery may be the solution for you. Through jaw surgery, we can enhance the beauty of your smile, correct facial skeletal discrepancies, along with airway problems. Dr. Broujerdi will provide you with the information you need to make a better informed decision regarding treatment options. At Cranio-Maxillofacial Surgery Institute we provide personalized care and stunning results.
Orthognathic Surgery
Orthognathic surgery or Corrective Jaw Surgery combines maxillofacial surgery or jaw surgery with orthodontics. The ideals of this type of surgery are to improve one’s bite and make chewing easier. The surgeries done are designed to correct misalignment of the jaw and make the jaw fit together properly. Facial imbalances such as an underbite, overbite or cleft palate can be corrected using orthognathic surgery. Orthodontics are used to correct malocclusions of the teeth and to improve gummy smiles, where large areas of gums are showing when a person smiles. TMJ disease can be corrected or prevented using orthognathic jaw surgery. Patients who have jaw problems that can’t be treated with orthodontics alone have orthognathic surgery to correct the jaw abnormality so the teeth work properly.
Surgery on the upper jaw is called a maxillary LeFort I osteotomy and surgery on the lower jaw is called a bilateral sagittal split mandibular osteotomy. A patient can have one or both of these surgeries at the same time in order to correct the alignment of the upper and lower jaw and to improve the functionality of the upper and lower jaw. Occasinaly the chin bone, sliding geniality is also moved for optimal facial aesthetics and balance. The surgery is generally done using incisions inside the mouth so that there is no external scarring visible.
The term “orthognathic surgery” is latin derivation of the word "Ortho" to strighten and "Gnathic" meaning the jaw. The surgery is used to treat dental and skeletal problems that can’t be treated with orthodontic treatments alone. Bones are cut and re-aligned and then held in place as part of the surgery using screws and/or plates.
The various indications for orthognathic surgery include the following:
Discrepancies between the upper and lower jaw alignment, which can be vertical, transverse or antero-posterior
Facial skeletal abnormalities that result in airway problems, sleep apnea or soft tissue problems
TMJ pathology that causes facial skeletal discrepancies.
Dr. Broujerdi is an oral and maxillofacial surgeon and craniofacial/plastic surgeon. He is aided by an orthodontist who straightens and aligns the teeth before and after surgery. For the convenience of our patients, there is an on-site state-of-the-art 3D Craniofacial Cone Beam CT Scanner (low dose radiation) by Kodak, 3D photographic imaging program by 3dMD and a 3D virtual surgery program by 3dMDvultus software which provides cutting edge diagnostic and treatment planning tools.
Dr. Broujerdi Combines his knowledge and training in both plastic surgery and maxillofacial surgery to reconstruct both soft tissue and hard tissue (bone) during corrective jaw surgery. This combination will provide you with a functional and aesthetic facial outcome.
WHO CAN BENEFIT?
Patient’s who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and congenital birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or "occlusion," problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws.
Deciding whether or not a person could benefit from corrective surgery on the upper jaw, lower jaw, or chin is usually determined by a multidisciplinary team of dental professionals comprised of an Orthodontist, and an Oral & Maxillofacial surgeon. Combining their respective specialties, they will determine what needs to be done to achieve the desired outcome and then create a treatment plan. This plan will likely involve orthodontic treatment to reposition teeth prior to the corrective surgery as well as additional orthodontic treatment after surgery, and the patient's entire treatment plan may be completed over one to two years.
PRE-SURGERY WORK UP
After completing pre-orthodontic teeth movement, patients will need facial skeletal X-Rays, dental models, dental splints, pre-surgery photographic imaging. In our practice we use a 3D Craniofacial Cone Beam CT Scanner by Kodak 9500 which is a low dose radiation x-ray. A 3D photographic image of the patient with the 3dMD cameras are obtained and combined with the 3D CT image together. Next a 3D computer model of the skin, soft tissue and bone is obtained with the aid of the 3dMDvultus software, which virtual surgery is preformed. This technology will prepare and allow the surgeon to visualize and calculate the correct movements of the jaw precisely before the actual surgery.
WHAT IS INVOLVED?
Weather the surgery will be done in a hospital, an outpatient surgery center depends on the procedure to be performed. The surgery may take as many as four hours to complete or as few as one hour. General anesthesia is used with a certified anesthesiologist monitoring the patient. Typically, the surgical incisions are made within the mouth so there are no or few small skin incision for the surgery. Once the bones of the chin, upper jaw, and/or lower jaw are repositioned, they may be held in place with small titanium screws and plates. In our practice we do not wire patients mouth shout. Rubber bands or a dental splint are used to guide the patient temporarily into a new bite.
Procedure is usually preformed as an inpatient hospital at St. Johns Health Center in Santa Monica or Cedar Siani Medical Center and Olympia Medical Center in Los Angeles. Dr. Broujerdi prefers seeing his patients the next day for follow up. You should expect a minimum of one week of down time after this procedure, some patient will require longer healing period. Dr. Broujerdi’s professional office staff will assist with post surgical care information and instructions.
RECOVERY
The surgeon will provide the patient with a diet to follow during the healing process as well as a timetable for moving back to a regular diet. The surgeon will advise the patient on any limitations on physical activity to observe during the initial healing period, which lasts approximately four weeks. Also, the surgeon will provide the patient with instructions for using prescription or over-the-counter medications to control pain. One to two weeks following surgery, the majority of patients are able to return to school or work. Eight to ten weeks are required for complete healing of the surgical sites.
Successful Orthognathic surgery can not only eliminate pain, restore function, improve quality of life, and boost self-esteem for the patient, but it can also improve his or her dental health by eliminating abnormal wear forces on the teeth, making it easier for them to brush and floss their teeth and allowing them to maximize the effectiveness of their home care as well as the benefits of regular professional cleanings. If you like to visit Corrective Jaw Surgery Los Angeles, please click on this link.
American Association of Oral & Maxillofacial Surgeons Annual Meeting, Philadelphia 2011 . 3-D Changes in the Upper Airway after Orthognathic Surgery