Skeletal Class II
Skeletal Class II surgery is also known as Class II orthognathic surgery. It is also referred to as backward mandible surgery. It is a surgical procedure to correct skeletal abnormalities associated with a Class II malocclusion. By definition, Class II is characterized by excessive overhang of the upper teeth relative to the lower teeth due to abnormal positioning of the upper jaw (maxilla) relative to the lower jaw (mandible).
What is a skeletal Class II malocclusion?
In the case of severe skeletal Class II, traditional orthodontic corrections, such as braces, may not be enough to completely address the problem. Therefore, skeletal Class II surgery is then performed to correct the underlying skeletal imbalances.
Assessment
The process typically begins with a thorough evaluation by the orthodontist and maxillofacial surgeon. X-rays, dental impressions, and other examinations are then performed to assess the nature and extent of the malocclusion. Once the treatment plan is established, surgery can be performed.e processus commence généralement par une évaluation approfondie de l’orthodontiste et du chirurgien maxillo-facial. Ensuite, les images radiographiques, les empreintes dentaires et d’autres examens sont effectués pour évaluer la nature et l’étendue de la malocclusion. Une fois que le plan de traitement est établi, la chirurgie peut être réalisée.
Operation
During surgery, precise cuts are made to the jawbones to allow for their proper repositioning. This may include forward, upward, or downward movements, depending on the patient’s specific needs. Once orthognathic surgery is performed, postoperative orthodontic treatment may be necessary to adjust the position of the teeth and ensure a proper bite.
It is important to note that skeletal Class II surgery is a major operation. The process can be complex and requires close collaboration between the orthodontist and maxillofacial surgeon to ensure the success of the operation.
What is the cost of Class II orthognathic surgery?
In general, orthognathic surgery is an expensive procedure due to its complexity and the level of expertise required. Costs may include preoperative consultations, surgical fees, anesthesia fees, hospitalization fees, postoperative care, and orthodontic fees if orthodontic treatment is required before or after surgery.
Consult several healthcare professionals, including maxillofacial surgeons and orthodontists, to get quotes specific to your situation. Some practices offer payment plans or may work with insurers to help mitigate costs, but this will depend on the individual situation and insurance coverage.
Why perform class II skeletal surgery?
Aesthetic improvement
A Class II malocclusion can often be associated with an unbalanced facial profile, excessive overhang of the upper teeth, or a seemingly receding lower jaw. Class II surgery can help improve facial appearance by restoring harmony to facial proportions.
Functional problems
A Class II malocclusion can cause functional problems such as difficulty chewing, speaking, or muscle tension. Surgery can help correct these problems by realigning the jaws to promote proper occlusion (teeth closure).
Respiratory problems
In some cases, a Class II malocclusion may be associated with breathing problems, such as airway obstruction. Surgery can help improve breathing by realigning the maxillomandibular structures.
Before/After Simulations of Class II Skeletal Surgery
Is Class II surgery painful?
Pain during surgery: Class II surgery is performed under general anesthesia, which means the patient is unconscious during the procedure and does not feel any pain. Therefore, the procedure itself is painless.
Postoperative pain: After surgery, it is normal to experience some pain, pressure, and discomfort. However, most patients manage pain well with pain medication prescribed by the surgeon and a cryotherapy headband.
Swelling and bruising: Swelling and bruising on the lower face are common. While this is not painful in itself, it can contribute to discomfort. Local cold and anti-inflammatory medications can help reduce swelling.
Respiratory discomfort: The patient may experience temporary respiratory discomfort during the recovery period.
Sensitivity to touch : The operated area may be sensitive to touch for a while, but this sensitivity decreases as healing progresses.
How to find a surgeon for a skeletal class II?
Recommandations
Talk to friends, family members, or colleagues. Their experiences and recommendations can be invaluable.
Reviews
Look for online reviews of potential surgeons. However, be critical and consider the diversity of experiences, avoiding relying solely on reviews.
Initial consultation
Schedule consultations with multiple surgeons to discuss your goals, ask about their experience, and see examples of surgical results.
What are the risks of surgery (skeletal class II)?
1. Bleeding
Although bleeding is usually controlled during surgery, there may be a risk of excessive bleeding postoperatively.
2. Infections
Infections are always a risk after surgery. Surgeons take precautions to minimize this risk, but it can still occur.
3. Anesthetic Reactions
As with any surgical procedure, there is a risk of allergies, adverse reactions or other complications related to anesthesia.
4. Bruising and Swelling
Bruising (accumulation of blood) and swelling are common side effects after surgery. They can contribute to postoperative discomfort and take time to resolve.
5. Bone Problems
Orthognathic surgery involves structural changes to the jaw bones. Problems such as non-healing, delayed healing, or poor bone healing may occur.
6. Speech difficulties
During the recovery period, some patients may experience temporary difficulty eating or speaking.
7. Temporomandibular Joint (TMJ) Problems
Joint problems, although rare, can occur after surgery and affect the function of the temporomandibular joints.
8. Aesthetic Dissatisfaction
Although the goal of surgery is often to improve facial aesthetics, there is a risk of unsatisfactory results or aesthetic disappointment.
What are the steps involved in an operation to correct a receding mandible?
1) Initial consultation
The process begins with an initial consultation with an orthodontist. During this phase, X-rays, dental impressions, and facial photographs may be taken to assess the severity of the malocclusion. Once the need for orthognathic surgery is established, the patient is referred to a maxillofacial surgeon.
2) Simulation
Computer simulation: A simulation can be performed to simulate the outcome and help the patient visualize the desired result. Perform a simulation of receding chin surgery.
The maxillofacial surgeon will conduct a thorough evaluation, including clinical examinations, medical imaging, and a detailed analysis of the malocclusion. A precise surgical plan is developed to determine the necessary jaw movements.
3) Preparation for the intervention
Before surgery, the patient may undergo preoperative orthodontic treatment to align the teeth and prepare the jaws for surgery. This may involve wearing braces for several months or even years.
4) Day of the intervention
During surgery, the maxillofacial surgeon makes precise cuts in the jaw bones to reposition them according to the established plan. The bones are secured in place with screws, plates, or other fixation devices.
5) Post-operative period
After surgery, the patient is usually monitored for a period of time in the hospital. The length of hospitalization depends on the complexity of the procedure and the patient’s recovery.
The patient then continues to recover at home, following the maxillofacial surgeon’s instructions. This may involve a liquid or soft diet for a period of time and taking precautions to avoid stress on the recently operated jaws.
6) Follow-up
Once the initial healing phase is complete, the patient often continues orthodontic treatment to adjust the position of the teeth and perfect the bite.
Developments after surgery
End of operation
The first few days after surgery are spent in the hospital for postoperative monitoring. Care includes pain management, bleeding control, and checking the patient’s general condition.
1st week
During the initial phase, diet may be limited to liquids or soft foods to avoid stress on the recently operated jaws.
1st month
Rest is essential during this phase. Physical activity should be limited, and the patient should follow the maxillofacial surgeon’s instructions for postoperative care, including cleaning the incisions.
After several months
Postoperative orthodontic treatment can begin to adjust the position of the teeth.
Speech therapy
In some cases, physical rehabilitation or speech therapy sessions may be recommended to facilitate recovery and restore normal function of the jaws and facial muscles.
Follow up
Regular follow-up visits with the maxillofacial surgeon are scheduled to monitor healing, adjust medications as needed, and address any patient concerns.
What are the benefits of ultrasonic cutting surgery?
This technique has several advantages in various fields of surgery, including maxillofacial and dental surgery.
Less damage to soft tissue : Piezoelectric instruments are specially designed to target bone tissue while sparing surrounding soft tissue, such as nerves, blood vessels and mucous membranes.
Less bleeding : The ultrasonic cutting technique causes less bleeding than traditional methods, which can improve the surgeon’s visibility during the procedure.
Less Trauma: Piezo surgery reduces overall tissue trauma, which can lead to faster post-operative recovery and less pain for the patient.
Reduced risk of complications : Due to its precision, piezo surgery can help reduce the risk of complications such as unintentional fractures or nerve damage.
Application diversifiée : Les instruments piezoélectriques peuvent être utilisés dans une variété de procédures, y compris l’extraction dentaire, la préparation du site pour les implants dentaires, la chirurgie parodontale, la chirurgie orthognathique et d’autres interventions en chirurgie maxillo-faciale.
Moins de vibrations : Contrairement à d’autres méthodes de coupe, la chirurgie par piezo génère moins de vibrations, ce qui peut être bénéfique dans les procédures sensibles.
Récupération postopératoire améliorée : En raison de la précision et de la réduction des traumatismes tissulaires, de nombreux patients signalent une récupération postopératoire plus rapide et un inconfort réduit par rapport à des méthodes chirurgicales plus traditionnelles.
What scars are left by orthognathic surgery?
Incisions for jaw surgery can be placed inside the mouth along the lower gum. Most of the time, there is no visible scar from the outside.
History of orthognathic surgery
Beginnings of maxillofacial surgery (19th century): The first surgeries on the maxillofacial bones were performed in the 19th century. However, at that time, understanding of facial growth and bone relationships was limited, and results were often unpredictable.
Early Orthognathic Surgery (First Half of the 20th Century): During the first half of the 20th century, orthognathic surgery made significant advances thanks to the work of pioneering surgeons such as Harold H. McNeil and Roy L. Ripley. They contributed to the understanding of jaw dysfunctions and the development of surgical techniques to correct them.
Evolution of surgical planning (1950s-1960s): The 1950s and 1960s saw the introduction of new methods of surgical planning, including the use of plaster models and cephalometric radiographs. Consequently, these advances allowed for better anticipation of necessary jaw movements.
Development of internal fixation surgery (1970s): The introduction of internal fixation, such as the use of titanium plates and screws to hold bones in position, revolutionized orthognathic surgery in the 1970s. This allowed for increased stability of surgical results.
Use of computer techniques (1990s onwards): With the advent of computers and advanced medical imaging, surgeons have been able to use computer-aided planning techniques to precisely design the necessary surgical movements.
Minimally Invasive Surgery (2000s onwards): Orthognathic surgery techniques have continued to evolve towards more minimal and less invasive approaches, thereby reducing visible scarring and speeding recovery.
Integration of Orthodontics (Today): Nowadays, orthognathic surgery is often integrated into comprehensive orthodontic treatment plans. Preoperative orthodontics is used to prepare the teeth and facilitate surgery, while postoperative orthodontics may be necessary to adjust the final position of the teeth.
Before/After Simulations
