Carolinas Center for Oral & Facial Surgery lies at the forefront of jaw surgery, leveraging the latest advancements in technology and expertise to deliver exceptional outcomes for their patients. The center’s oral and maxillofacial surgeons specialize in the diagnosis, treatment, and correction of complex jaw alignment issues. CCOFS offers patients cutting-edge solutions for addressing conditions such as asymmetrical jaws, sleep apnea, and orthognathic problems. Through a comprehensive and multidisciplinary approach, the oral surgeons at CCOFS work closely with patients to develop personalized treatment plans that combine orthodontics, surgery, and advanced diagnostic tools to achieve optimal outcomes and transform lives.
CCOFS's oral and maxillofacial surgeons stay current with the latest techniques and best practices through ongoing education and training, allowing them to provide comprehensive solutions for complex jaw-related issues, participating in monthly case-sharing conferences, where they discuss complex cases, share techniques, and review pre- and post-operative evaluations to continually improve outcomes and assessments. These conferences foster collaboration, knowledge-sharing, and staying up-to-date on the latest developments in the field. “CCOFS is on the leading edge of the technology with jaw surgery and beta sites for virtual surgical planning, 3D printing bone graph, and in-house surgery models,” says Dr. Farrell. This commitment to innovation enables them to deliver exceptional patient care and life-changing outcomes.
Corrective jaw surgery, also known as orthognathic surgery, is a complex procedure that involves correcting various conditions and issues related to the upper and lower jaws. These conditions can have a significant impact on a person's overall health, function, and appearance. For instance, some individuals may be born with conditions that cause their jaws to grow at different rates, leading to asymmetry, functional, and aesthetic problems. Others may experience mandibular retrognathism, where the lower jaw is smaller than normal, or prognathism, where the lower jaw is larger than normal.
In some cases, patients may have congenital skeletal and dental malocclusions, where their jaw grows in an asymmetrical way from birth, making it difficult for orthodontics alone to correct the bite. Additionally, functional challenges such as overbite, underbite, or open bite can also necessitate jaw surgery. These functional challenges can lead to difficulties with eating, speaking, and even breathing. They can also cause temporomandibular joint dysfunction, myofascial pain, and sleep apnea.
Corrective jaw surgery is a highly personalized procedure that requires a thorough evaluation of each patient's unique needs and anatomy. To develop a customized treatment plan, oral surgeons at CCOFS meet with their patients for a one-hour consultation, then conduct a comprehensive assessment that includes gathering medical history, performing a physical examination, and utilizing diagnostic imaging techniques such as radiographs and cone beam CT scans. With this data, surgeons can then determine the best course of action, that can improve oral health and enhance aesthetics.
To address these issues, oral surgeons perform various types of jaw surgeries. Lower jaw surgeries include procedures such as Bilateral Sagittal Split Osteotomy (BSSO), Intraoral Vertical Ramus Osteotomy (IVRO), and Subapical Osteotomy. Upper jaw surgeries may involve multiple-piece Lefort Osteotomies. The key to successful jaw surgery is careful planning and execution. Patients have three options: leaving their bite unchanged, camouflage treatment, or a combined approach that involves orthodontic alignment followed by surgical correction. The latter often yields the most optimal results in terms of balance, proportion, symmetry, and function. Dr. Howell clarifies, “Different types of jaw surgeries are dependent upon the relationships of the jaws, the facial harmony and balance, the airway evaluation, and bit or occlusion the OMSs are looking to achieve. We will either move the upper or lower jaw, or a combination of both, moving the upper and lower jaw together. We can also move the chin for facial balance, as well as the base of the tongue forward to improve the airway.” By evaluating each patient's unique situation and developing a tailored treatment plan, oral surgeons can help their patients achieve improved oral health and overall well-being.
“Different types of jaw surgeries are dependent upon the relationships of the jaws, the facial harmony and balance, the airway evaluation, and bit or occlusion the OMSs are looking to achieve. We will either move the upper or lower jaw, or a combination of both, moving the upper and lower jaw together. We can also move the chin for facial balance, as well as the base of the tongue forward to improve the airway.”
- Dr. Howell
The use of advanced imaging technology plays a vital role in the planning and execution of jaw surgery at CCOFS. This cutting-edge approach enables oral and maxillofacial surgeons to achieve precision and accuracy, resulting in faster procedures and more predictable outcomes. The integration of 3D scanning and virtual surgical planning allows patients to visualize the anticipated results of their surgery, providing greater peace of mind and increased satisfaction. This innovative technology also replaces traditional impression-taking methods, providing a more accurate and detailed understanding of the patient's anatomy. Dr. Howell notes that virtual surgical planning has become one of the most important parts of corrective jaw surgery in the last 20 years, as it allows oral surgeons to have the most advanced and accurate plan. By virtually planning and simulating the procedure before performing the actual surgery, oral surgeons can anticipate and address potential issues beforehand, refine their techniques, minimize potential complications, and ensure a smoother recovery for patients. This technology enables surgeons to significantly reduce the risk of errors and complications, providing patients with greater peace of mind.
Oral surgeons at CCOFS prioritize patient comfort and confidence by addressing concerns and anxieties before surgery. By identifying and addressing concerns ahead of time, patients can feel prepared for a stress-free recovery and optimal outcomes. A long track record of safety in jaw surgery at CCOFS instills confidence, emphasizing the importance of proper medical clearance and screening. To further minimize risk, oral surgeons work closely with patients to ensure post-operative compliance, providing guidance and care to facilitate a smooth recovery. With extensive experience in performing 300-400 jaw surgery cases annually, patients can trust that their surgeon has the expertise to guide them through the process.
In addition to office-based procedures, oral surgeons can perform complex surgeries in a hospital setting, where trusted anesthesia teams and hospital staff provide exceptional care and attention to detail. Dr. Dammling also notes that CCOFS is one of the largest groups in the nation that does outpatient and hospital-based jaw surgery. This allows for a range of benefits, including comprehensive care, advanced anesthesia techniques, and state-of-the-art facilities. CCOFS' skilled team of board-certified oral and maxillofacial surgeons has extensive experience in performing jaw surgeries. They stay up-to-date with the latest research and advancements in the field, ensuring patients receive the most effective and minimally invasive treatments. The ability to perform in-office surgery reduces the risks associated with hospitalization, such as infection and longer recovery times. Hospital-based services are also available for patients requiring more complex procedures or close monitoring. With CCOFS, patients can trust they are receiving expert care from a highly experienced team.
Patient preparation is a crucial aspect of jaw surgery care at CCOFS. Pre-operatively, patients receive detailed instructions on medication management, pain control, dietary restrictions, and physical activity guidelines to minimize complications and ensure a smooth recovery. After surgery, patients receive ongoing support through regular check-ins and access to a dedicated phone number for questions and concerns. This personalized attention alleviates anxiety and uncertainty, enabling patients to focus on their recovery and achieve optimal outcomes.
Oral and maxillofacial surgeons also educate patients on essential aspects of recovery, including nutrition, sleep, hygiene, and exercise. Patients receive dedicated care from their OMS, with follow-up appointments scheduled within 24 hours, one week, and one month. With outpatient surgery available at CCOFS, patients can recover at home, rather than in a hospital setting. The recovery process typically takes several weeks, with patients returning to daily activities by week three and resuming a normal diet by the end of the first month. Patients are advised to follow a soft food diet and take prescribed medication during this time. “A prepared patient is a healthier patient. That’s why we bring in our patients prior to surgery, making sure they have everything they need for recovery. As far as nutrition, we make sure they have the appropriate foods available to them during recovery, they have the appropriate tools they need to have a more comfortable experience after surgery. Risks are always going to be there, discomfort is always going to be there, but being able to mitigate that ahead of time is what makes us different,” says Dr. Thakkar.
Oral and maxillofacial surgeons collaborate with orthodontists to ensure optimal alignment of the teeth, both pre- and post-operatively. This collaborative effort requires effective communication and sharing of patient records, notes, and recommendations between specialists. The importance of comprehensive care is emphasized by Dr. Farrell, who highlights the oral surgeons' direct involvement with orthodontists throughout all phases of surgery. This collaborative approach ensures that teeth are properly aligned before surgery and that any necessary adjustments are made post-operatively. By working together, oral surgeons, orthodontists, and other specialists provide patients with exceptional care and support throughout their recovery process.
At CCOFS, jaw surgery has the power to transform lives, and is evident in the remarkable stories of patients who have undergone these life-changing procedures. Dr. Thakkar recalls a young woman whose misaligned jaw was causing breathing difficulties and sleep disruptions. Following mandibular advancement surgery, she reported a significant improvement in her overall well-being, including enhanced breathing capacity and improved sleep quality. This comprehensive transformation not only boosted her self-esteem but also restored her ability to enjoy meals and sleep peacefully. Dr. Howell's patient, once hesitant to smile due to aesthetic concerns, gained newfound confidence after corrective jaw surgery. Dr. Franco's patient, who struggled with severe obstructive sleep apnea, could resume long-distance driving without fear of nodding off at the wheel after corrective jaw surgery. Dr. Dammling notes that patients with obstructive sleep apnea often experience a notable improvement in their overall health and functioning after surgery, characterized by increased energy levels and reduced daytime fatigue. Dr. Wessel recalls an impactful patient story of someone who struggled with self-image and was bullied in high school for having a jaw deformity, making it hard for him to speak and eat. The impact on his self-esteem led him and his family to work with Dr. Wessel to undergo jaw surgery. Afterwards, he transformed into a new, confident young man, whose outlook changed for the better. These case studies illustrate the profound effects of jaw surgery, which can have a lasting impact on patients' physical and emotional well-being.
For the oral and maxillofacial surgeons at CCOFS, performing jaw surgery is a profoundly rewarding experience. The opportunity to alleviate patients' suffering and transform their lives is a constant source of inspiration and motivation. Seeing patients overcome the physical and emotional challenges associated with jaw misalignment, sleep disorders, and other conditions is a testament to the power of their expertise and dedication. Oral and maxillofacial surgeons take great pride in knowing that their work is not only improving patients' physical health but also enhancing their overall well-being, confidence, and quality of life. The sense of fulfillment that comes from witnessing patients' newfound ability to eat, sleep, and live comfortably is a reward that far exceeds the challenges of the surgical process itself. By taking a personalized approach to corrective jaw surgery, orthognathic surgeons can help patients achieve optimal alignment and function, enhancing their overall quality of life.
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