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What is Surgery First Approach?

The surgery first approach involves jaw surgery BEFORE orthodontic tooth movement.

When a patient has a skeletal imbalance between the upper and lower jaws, their teeth, lips, face, and chin are not aligned. For moderate to severe skeletal jaw imbalance, orthodontics or growth modification may not be enough to correct the problem. Jaw surgery is a correction under General Anesthesia to correct the skeletal jaw imbalance. This is done by specialist oral surgeons in a hospital setting, and careful planning between the oral surgeon and the orthodontist is needed beforehand. Do expect a downtime of 3-6 weeks for recovery at home.

FAQs

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To chew and bite better, patients with jaw imbalances often have teeth positioned to compensate for this. For example, in a long jaw patient, this means that the upper teeth lean forward and the lower teeth lean backward to try and meet each other. This is called dentoalveolar compensation and occurs naturally.

Traditionally, a patient who needs jaw surgery undergoes braces before surgery to orthodontically move teeth out of their compensated position. This removal of dentoalveolar compensation reveals the true severity of the jaw imbalance! The original underbite or overbite is made worse, and the facial profile will look more exaggerated. Unfortunately, this means that the patient’s bite and the face get much worse before it gets better by jaw surgery correction.

Traditional jaw surgery often requires patients to go through a period of 10-15 months of ‘decompensation’ to get them ready for jaw surgery. This treatment sequence of traditional jaw surgery braces is often a difficult period for patients as they grapple with increased difficulty in eating, speech problems, and a worsening profile.

Patients with long jaws often wait a long time for growth to end before starting treatment. Therefore, it’s a bitter pill to swallow if they undergo traditional dental decompensation before getting the facial correction they have been waiting for.

Patients with jaw imbalances are corrected with jaw surgery first, and then the teeth are moved into their correct relationship (dental decompensation) after surgery. In this way, patients enjoy early facial correction without going through the traditional method of removing natural, inbuilt dental compensation before corrective jaw surgery.

After jaw surgery, the Regional Acceleratory Phenomenon (RAP) occurs in response to the surgical stimuli. RAP increases bone metabolism and the healing capacities of the affected jaw bone and soft tissues, thereby speeding up tooth movement. Micro-osteoperforations to speed up braces treatment are based on the same RAP response after bone injury. By understanding RAP, our braces specialists can effectively and quickly move teeth into their correct position after jaw surgery to reduce overall treatment time.

This complex answer requires detailed investigations by our Orthodontic Team with a complete set of digital records. Input from our surgical team is very important to determine the suitability of Surgery-First Jaw surgery in Singapore for you.

3 important questions for Surgery-First jaw surgery:

  1. Is there any dental interference blocking the Surgery-First approach?
  2. Can Surgery-First jaw surgery provide enough skeletal and facial change?
  3. Does the patient’s schedule permit Surgery First jaw surgery?

At MyBracesClinic, our Orthodontic Team uses the following for Surgery-First Jaw Surgery:

  • Traditional Fixed Braces
  • Damon Braces
  • Damon Ceramic Braces
  • Invisalign
  • Incognito Lingual Braces 


MyBracesClinic has successfully used Invisalign for multi-piece, Surgery-first cases, and Dr Poon Kee Hwang has presented this technique to both local and international audiences to share her expertise.

Which braces system to use will depend on the type of skeletal problem you present, budget, and lifestyle considerations.

MyBracesClinic collaborates closely with Specialist Oral Maxillofacial Surgeons to provide a multi-disciplinary team approach necessary for successful treatment outcomes. We understand this is a big discussion in your life, so bring your loved ones for your first consultation with us. We would happily answer your questions and discuss our cases with you.

Click here to make an appointment today!

Related topics

Alternatives to Jaw Surgery

Alternatives to Jaw Surgery

Jaw surgery to correct skeletal imbalance is a major undertaking and all alternatives must be evaluated before finalising on a jaw surgery plan.
Do I Need Jaw Surgery?

Do I Need Jaw Surgery?

If you have a skeletal jaw imbalance, your life may be affected in many ways. When the skeletal jaw imbalance becomes so severe that it is beyond the healthy. ‘Safe’  boundaries of camouflage orthodontics, such as corrective jaw surgery, are certainly an option.

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