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Anaesthesia for orthognathic surgery 

Anaesthesia for orthognathic surgery
Chapter:
Anaesthesia for orthognathic surgery
Author(s):

Viki Mitchell

DOI:
10.1093/med/9780199564217.003.0018
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date: 26 February 2020

Orthognathic surgery involves the manipulation of the facial skeleton: the maxilla, mandible, and dentoalveolar segments (the portion of the jaw supporting the teeth), these can all be surgically repositioned to treat malocclusion and deformity. The term orthognathic derives from the Greek words orquos, meaning to straighten, and gnaqos, which means jaws. Hence orthognathics is surgery to straighten the jaws.

The majority of patients are referred to the orthognathic team by an orthodontist because they have malocclusion which cannot be corrected by conservative measures (braces and appliances) alone. Abnormalities of dental alignment (the bite or occlusion) relate not only to the position of the teeth, they are intimately connected with the relative positions of the upper and lower jaw. Facial harmony depends on these relationships, but malocclusion does not only influence facial aesthetics, there are serious functional implications. Chewing, mastication, speech, temporomandibular joint (TMJ) function, the ability to nose-breathe, and the ability to maintain good oral hygiene may all be compromised. The correction of these functional elements underpins the rationale behind treatment.

A multidisciplinary team approach is standard, and treatment may take years to reach completion. An orthodontist is always involved if dental occlusion is at issue; the orthodontic workup generally starts a year or two before surgery and continues postoperatively. In addition, restorative dentists, dental hygienists, psychologists or psychiatrists, throat, nose and ear, plastic and neurosurgeons, speech therapists, specialist nurses, and audiologists may all contribute to planning and treatment.

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