Severe orthodontic cases may require surgery in order to correct the problem. This can be the case when a bite is extremely irregular, jawbones are not aligned properly or there is some abnormality with the jawbone. When surgery is required, Dr. Schatz works with highly skilled oral and maxillofacial surgeons.
The oral and maxillofacial surgeon has specialized training in treating problems of the mouth, jaw, face and skull. Sometimes surgery is needed to realign the jawbone so the teeth can meet properly. Surgery may also be needed to shorten or lengthen the jaw. These types of surgery are considered major and require about two weeks for recuperation.
- Dr. Schatz is experienced in working with complex combined orthodontic/surgical treatment, including orthognathic/jaw surgery, as a team with experienced oral surgeons
- Temporary Anchorage Devices – Dr. Schatz is experienced in utilizing mini implants (TADs) for complex orthodontic movements
- Dr. Schatz routinely partners with restorative dentists, periodontists, and other dental specialists in tailoring an overall comprehensive dental plan for adultpatients (and any younger patients that require more complex treatment i.e. implant replacement of teeth, surgical treatment etc…)
Types of Orthodontic Surgery
Surgery on the upper jaw is called maxillary osteotomy. This type of surgery helps correct an upper jaw that protrudes or recedes significantly. It also helps close an open bite or can correct a crossbite.
A mandibular osteotomy is surgery performed on the mandible, or lower jaw. Most mandibular osteotomies are performed to correct a lower jaw that protrudes or recedes too far.
If both your upper and lower jaws are affected and surgery is required to remedy the condition, the surgery is called a bimaxillary osteotomy. The use of 3D modeling software is often utilized to plan these complex types of surgeries.
Orthodontic surgery, also known as orthognathic surgery, may be recommended for several reasons. This type of surgery can help:
- Adjust your bite if you have a severe crossbite, overbite or underbite
- Correct problems with the symmetry of your face
- Help relieve pain due to temporomandibular joint disorder
- Repair congenital conditions like cleft palate
- Repair damage done through injury
- Make biting, chewing or swallowing easier
- Address mouth breathing
Your orthodontist will examine your teeth and bite and make a recommendation based on the findings. If surgery is needed, the type and process will be discussed with you during a consultation.
Types of Appliances
(examples include Distal-Jet, Pendulum appliance, Carriere Distalizer)
Distalizer appliances are used to adjust the bite by pushing upper teeth backward. This type of appliance can be used to reduce an overbite related to the bite and create space for teeth that have inadequate room.
Temporary Anchorage Device (examples include TAD’s and Miniplates)
A Temporary Anchorage Device (TAD) is typically used when Dr. Schatz needs to create a temporary custom tooth movement system to achieve a superior cosmetic result. TAD’s can be in place for a few months or possibly for the duration of your orthodontic treatment depending on your individual circumstances.
Elastics (Rubber Bands)
Wearing elastics (or rubber bands) improves the fit of your upper and lower teeth. Wear rubber bands as instructed and remember that the rubber bands work far more efficiently if they’re worn as prescribed.
The Herbst® appliance reduces overbite by encouraging the lower jaw forward and the upper molars backward. This fixed appliance is used mostly for younger, growing children and is worn for about 12-15 months.
The palatal expander “expands” (or widens) your upper jaw by putting gentle pressure on your upper molars each time an adjustment is made. Your orthodontist will instruct you about when and how to adjust your expander. When you achieve the desired expansion, you will wear the appliance for several months to solidify the expansion and to prevent regression.
Positioners complete the final tooth movements in your orthodontic treatment. With your full cooperation, you should only need to wear the positioner appliance for four to eight weeks.
Retainers may be removable or fixed. They hold your teeth in their new, correct positions after your teeth have been straightened. Your orthodontist will instruct you on how to care for your retainer and about the duration of the wear. Wearing your retainer as directed is crucial to prevent regression of your treatment.
Separators or Spacers
Separators are little rubber doughnuts that may be placed between your teeth to push them apart so that orthodontic bands may be placed during your next appointment. The separators will be removed before we place the bands. Separators do not mix well with sticky foods, toothpicks, or floss.
Headgear is used to treat patients whose teeth are in an overbite, with the upper jaw forward of the lower jaw, or an “underbite” with the lower jaw forward of the upper jaw. Headgear gently “pulls” on your teeth to restrict further forward growth of your upper teeth and jaw.
Do not hesitate to ask questions, and gather all the information you need in order to feel comfortable with the procedure. Dr. Schatz is happy to provide answers. Contact Schatz Orthodontics today to schedule an appointment for a consultation.