What it is
This is the branch of dentistry that treats diseases of the oral cavity and its adjacent structures: facial trauma and deformities, whether congenital or acquired, and trauma and deformities of the jaws - across the region between the hyoid bone and the anterior wall of the frontal sinus, and from the tragus to the nasal pyramid.
The diseases involved include tumours, maxillary cysts and manifestations associated with systemic disease. Facial deformities range from the after-effects of cancer and severe trauma to developmental disorders, such as prognathism (enlarged jaws) and micrognathism (reduced jaws), or a combination of the two.
How it works
Care may be provided on an outpatient basis or in hospital. Minor surgery is carried out at the clinic, in the great majority of cases under local anaesthesia: removal of impacted teeth, small benign tumours, cysts and periapical lesions, dental implants and surgery to prepare for prosthetic work.
Major surgery is carried out under general anaesthesia in a hospital setting and calls for greater care, with dedicated preparation and post-operative follow-up.
Orthognathic surgery
Orthognathic surgery corrects growth disorders of the jaws - dentofacial anomalies such as prognathism (class III, chin forward) and retrognathism (class II, chin back). These can give rise to disorders of the bite, of the temporomandibular joint and of breathing, as well as affecting facial appearance.
In most cases the surgery is performed from inside the mouth; it is rarely done with an incision on the face. The procedure consists of releasing the jaw by means of a Le Fort I osteotomy and/or a sagittal split osteotomy of the mandible. In some cases an osteotomy of the chin improves the aesthetic result. Fixation in the new position is done with titanium plates and screws.
The cost varies from case to case, but at present most Brazilian health plans and insurers cover part or, depending on the policy, all of the amount.
Who it is for
Treatment is indicated for patients with facial deformities involving the teeth and the bones of the face that cannot be resolved by orthodontics alone - because the problem lies in the bones (mandible and/or maxilla) and not only in the position of the teeth within the arch. Diagnosis is made jointly by a dentist specialised in orthodontics and an oral and maxillofacial surgeon.
Our team is complete: two oral and maxillofacial surgeons, a plastic surgeon and an ear, nose and throat surgeon. This allows multidisciplinary assessment and, within the same surgical session, orthognathic surgery, rhinoplasty, correction of a deviated septum and treatment of associated airway conditions such as obstructive sleep apnoea syndrome (OSAS).