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Orthognathic Surgery

Introduction

Function and aesthetics play a central role in the maxillofacial region and are closely interrelated. Besides functional improvement orthognathic surgery usually has a very positive effect on aesthetics.

Professor Bill has decades of experience in all fields of orthognathic surgery and aesthetic facial surgery. He has contributed to and further developed surgical procedures and is active nationally and internationally as a surgeon and invited speaker at lectures, seminars and conferences. Together with orthodontic colleagues, he has authored and co-authored numerous scientific papers and book contributions.

As orthognathic surgery is a highly specialised surgery in its own right, a detailed brochure has been published, which you can download here

(German language only):

The procedures described here are all based on the principle of harmonising and perfecting the areas of the face that are important for aesthetics: Nose - Jaw - Chin.

 

As these are aligned, the term ‘aesthetic axis’ was introduced.

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The following procedures are described and explained in more detail for the aesthetic axis nose - jaw - chin:

 

  • Repositioning surgery of the maxilla

  • Repositioning surgery of the mandible

  • Combined repositioning surgery of the maxilla and mandible

  • Palatal expansion to widen the maxilla

  • Corrective chin surgery

  • Nose corrective surgery (rhinoplasty)

  • Other aesthetic surgery procedures

 

These procedures can be used to surgically correct practically any jaw malposition and restore and perfect the aesthetic axis of nose - jaw - chin.

 

A detailed interdisciplinary preliminary examination is carried out together with your orthodontist to determine which procedure is to be performed and what the individual treatment steps are.

Video Orthognathic Surgery

Procedures

The procedures are performed under anaesthetic in the clinic where you will also be accommodated and cared for as an inpatient. Some procedures can also be performed on a day patient basis. You can therefore be discharged a few hours after surgery. 

 

Orthognathic surgery procedures are very wide-ranging and must be planned individually. They can be divided into the following groups:

 

 

These procedures can be used to surgically correct practically any jaw misalignment.

Temporomandibular joint (TMJ) positioning - Würzburg concept

The special feature of all jaw repositioning procedures is that the position of the TMJ is continuously maintained throughout the procedure. This is one of the special features of the surgical procedure performed by Professor Bill (‘Würzburg Concept’). It has therefore been statistically proven that TMJ disorders occur less frequently after surgery with this technique.

Osteotomy of the Maxilla

Surgery is performed within the mouth in the mucosal fold of the maxilla. Therefore, no scars are visible from the incision.

 

The maxilla is osteotomised transversely above the roots of the maxillary teeth. This allows the tooth-bearing part of the maxilla to be moved in any desired direction according to the surgical planning. Customised prefabricated surgical wafers determine the exact position of the maxilla and mandible in relation to each other. The maxilla is then fixated in its new position using titanium mini plates and screws.

 

The surgical wound is closed with thin silk threads. These are removed after about ten days.

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Osteotomy of the Mandible

Surgery is performed within the mouth at the posterior part of the mandible. Therefore, no scars are visible from the incision.​​
 

The mandible is osteotomised bilaterally in its posterior region. The frontal tooth-bearing part of the mandible is then moved forwards or backwards in any desired direction according to the surgical planning. The exact position of the maxilla and mandible in relation to each other is fixed by customised prefabricated surgical wafers. The new position of the mandible is fixed with three titanium screws in the mandibular angle on each side.

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The surgical wound is closed with thin silk threads. These are removed after about ten days.

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Combined Bimaxillary Osteotomy of the Maxilla and Mandible

In the case of extensive misalignments, a combination of maxillary and mandibular osteotomy can also be performed. For reasons of secure positioning of the fragments and the temporomandibular joints, the maxilla is always repositioned first.

Palatal Expansion

If the maxilla is too narrow and cannot be widened using orthodontic methods alone, the palate is widened as part of orthodontic pre-treatment. This involves weakening of the maxilla in order to promote orthodontic expansion.

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The procedure is usually performed on an outpatient basis under local anesthesia. Very extensive procedures also can be performed under sedation (sleep combined with local anesthesia) or under general anesthesia. You can be discharged after a few hours.

 

Surgery is performed inside the mouth in the mucosal fold of the upper jaw. This is why no scars are visible from the incision. The maxilla is osteotomised transversely above the roots of the maxillary teeth to weaken the bone. Depending on the expansion system used, an expansion appliance (e.g. distractor) can be fixed to the palate or the maxillary teeth during the procedure. Alternatively, the appliance is inserted and activated by the orthodontist after the procedure.

 

The surgical wound is closed with thin silk threads. These are removed after about ten days.

 

Orthodontic palatal expansion should begin immediately after the procedure.

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Genioplasty
(Corrective Chin Surgery)

Genioplasty (including Chin Wing Osteotomy, Chin Augmentation, Chin Repositioning Surgery) is of great importance for harmonizing the Aesthetic Axis nose - jaw - chin. It may also be necessary in case of orthognathic surgery to normalize muscular function and improvement of mouth closure. For this reason, genioplasty  should only be performed by an experienced specialist.

Procedure

Surgery is performed under general anesthesia. Depending on the extent of procedure, surgery is also possible on a day-case basis. In this case, you can be discharged after a few hours.

The procedure is performed intraorally in the mucosal fold of the mandible. Therefore, no scars are visible. The lower edge of the lower jaw is cut transversely below the roots of the mandibular teeth. This allows the split bone to be moved in the desired direction. Here it is fixed in its new position with mini plates and titanium screws.

 

The intraoral surgical wound is closed with thin silk threads. These are removed after about ten days.

Video Corrective Chin Surgery

Prof. Dr. Dr.

Josip S. Bill

Mund-Kiefer-Gesichtschirurg

Ästhetische und Wiederherstellende Gesichtschirurgie

Standorte

Praxis Dr. Boris Bill 

Tattenbachstrasse 12

D-80538 München 

Informationen und Termine:
Telefon +49-151-7029 2113
E-Mail: kontakt@billmedical.de

Nürnberger Strasse 20-22

D-63450 Hanau

Praxis Andreas Müller
 

© 2024 by Bill Medical  

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