Disturbances in the skeletal growth of either the maxilla and the mandible, can lead to the appearance of facial skeletal malformations, which in turn cause either functional and esthetic disorders, which can contribute to the psychological burden on people with orthognathic problems. Functional disorders concern problems dealing with mastication, swallowing, speech, and the function of the temporomandibular joint. Esthetic disorders as a consequence of facial malformations in patients with orthognathic problems, contribute greatly to the appearance of psychosocial maladaptive tendencies, resulting in the psychological disorder of those patients.
Some orofacial anomalies can concern only the improper arrangement of teeth in the dental arches, in other words the whole problem may be the existence of “crooked teeth”, which can be corrected by the orthodontist by placing various orthodontic devices (“braces” etc.). Severe disorders of the facial skeletal growth yet demand surgical intervention to rearrange the maxilla or/and the mandible in a more normal position and relation between them. Ordinary dentofacial deformities which include hypoplasia or overgrowth of the jaws (retrognathia, micrognathia, prognathism or macrognathia etc.), or improper arrangement of the dental arches (crowding/turning of the teeth of either the maxilla and the mandible, overbite, overjet of the front teeth, etc.), can cause difficulties in mastication, swallowing, speech and breathing.
Surgical correction of these problems or orthognathic surgery as it is usually called, is often performed in conjunction with orthodontic therapy as well as with reconstructive dental treatment. After a careful diagnostic approach and prudent planning of the surgical therapeutic intervention, the final result can be predicted with great accuracy, ensuring for the patient not only the achievable but also the absolutely desirable. Orthognathic surgery is usually performed in a hospital setting under general anesthesia, and usually patient’s hospitalization is short, being in most of the cases just one day clinic (ODC).
At this point we should also mention the congenital malformations, i.e. birth defects, such as cleft lips (old improper term harelip), and cleft palates (old improper term wolf mouth), which result when all or some parts of the oral and nasal cavities do not grow in common during embryonic development.
Oral and maxillofacial surgeons as team members, play an important role in the carefully and well orchestrated program of multiple reconstructive surgical operations, in which these patients should undergo since birth to adulthood. The objective is to achieve the full restoration of the jaws and the perioral tissues of the face, which leads to normal function and appearance of the patients. Therapeutic approach should include the forethought and care to restore function, appearance, eating, speech and hearing, as well as the ensuring of healthy sentimental and psychological development of cleft patients.