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orthognathic surgery Questions and Answers

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Question:
I've been told I have a pretty severe over bite and should have oral surgery to correct it because it causes serious pain in my jaw and popping when I chew. The way the procedure was described to me is that there would be incisions made on either side of my lower jaw, then they would lengthen it and put screws in my jaw. Is there any way that this surgery can be done with out having to get braces as well?
Answer:
The standard of care leans towards orthognathic surgery (ie: corrective jaw surgery) involving atleast an oral & maxillofacial surgeon and an orthodontist. Proper tooth alignment can be critical for a stable and acceptable outcome.
David King, DDS
Wilmington, DE


Question:
I have a bad underbite. I had a surgery consult, and had been planning on having the surgery at the end of June. They planned on moving my upper jaw forward and possibly moving the lower one back also. They were also going to shorten my upper jaw. Then I found out my insurance doensn't cover the surgery and it is likely to cost 30-35,000 dollars. I can't afford that! I'm really insecure about my smile, and I have a lot of problems eating. Is there any way to get my insurance company to cover it? Do you know of any companies that do cover that kind of surgery?
Answer:
Kelly, Unfortunate for many, insurance companies often apply the cosmetic surgery rules to orthognathic surgery. They feel the establishment of a functional bite is nothing more than cosmetic surgery, and most companies will not cover cosmetic surgery. It may take a number of appeal and review letters to get the company to assist you. You may need to make a number of calls to the company, and have both your doctor's office and your employee benefits rep make calls, too. If it can be a benefit to any medical problems you have, e.g.TMJ, gastric problems, air way problems you might get a favorable responce. Check also that your benefit handbook excludes or does not exclude corrective jaw surgery. It may mean changing docs, but if they do cover it it may mean you have to see a new provider. Good luck
Charles McNamara, DMD
Winter Park, FL


Question:
Dear Dr., My 3 year old daughter has an open bite. We have been reffered to an oral surgeon and told that surgery would be required. Are these procedures usually preformed on children of this age and if so, how does this affect future bone growth and development? Also, could you help me find more information about Le Fort I osteotomy on the web to help us better understand this procedure?
Answer:
The correction of an open bite is often done with a Lefort I osteotomy. The majority of the patients that undergo this procedure are older than 15 years old enless they have been diagnosed with a facial syndrome that requires a staged surgical correction. In these patients the final effects on overal growth and developement is unclear because of their underlying condition. For this reason I would be perfectly clear about your childs long term treatment plans as well as the primary diagnosis. Once you know this information you will be able to make a much better decision. For additional information about Lefort I osteotomies I would reccommend researching these key words on the web and at your local public library. Orthognathic surgery Craniofacial surgery Jaw corrective surgery good luck


Question:
my son is 12yrs of age and possibly needs mandibular advancement also 2supernumerary teeth behind#8/9removed 4premolars to be determined+4 3rdmolars.why would they remove so many teeth? and what is mandibular advancement? How long would it be for all this to be over? please help
Answer:
In general it appears that your son has been diagnosised with Mandibular Hypoplasia. The correction of this condition is performed with a procedure know as Orthognathic Surgery. If you are interested in the sequencing of this treatment you can look at the AOMS Home page or speak to a Board certified Oral & Maxillofacial Surgeon. As far as when his treatment will be over is difficult to say specifically, however in general the whole process can take up to two years and surgery is timed after your son has completed his facial growth. Good Luck


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