This assessment involves:
- Obtaining a low dose, high resolution CT scan, using our very specific protocol. Please note cone beam images aren't high enough resolution for custom plate manufacture, therefore are not used for the O&O assessment.
- Intra-oral digital scan
- Intra and extra oral photos
The raw CT data is "segmented" so each individual bone/piece of bone is able to be moved independently of one another. The intraoral scan of your teeth is then superimposed on top of the CT data. This is a very time intensive procedure using some very amazing advanced computer software.
The process enables you to see the layers that make up your jaw, skin, teeth and muscles, and the inter-relationship of all the different parts that make up your face. Once the data is prepared we arrange an appointment with our surgeon.
This appointment goes for 1.5 hrs - 2.0 hrs duration. During the appointment the surgeon will
1. Show you digitally on the computer screen your airway, and your head/neck skeleton as it is currently positioned
2. Discuss "ideal" position for the facial bones to gain maximum improvement of your presenting symptoms
3. Discuss the best way to achieve this position
4. Show you the effect that moving the bones into their ideal position will have on your airways.
We will be able to advise whether any orthodontic treatment will be required prior to surgery. We are able to assess where your teeth are currently in relation to each other, and where they will be after surgery. In many cases orthodontic treatment is not necessary prior to surgery unless the existing position of the teeth will prevent the movement of the jaw bones into the ideal position, as observed in the planning.
Orthodontic treatment is usually required after surgery. The jaw surgery can move the bone, it does not move individual teeth - this is what the orthodontic treatment is for, to create the ideal relationship between the teeth (occlusion) post surgery.
We are often asked what a person will look like after surgery. Technology has enabled us to be able to predict the outcome with regards to placement of the skeletal bones. It can't yet predict the soft tissue recovery post surgery.
There will be some tightening of the soft tissues where the facial bones are moved forward/outward, this may eliminate/reduce definition of some wrinkles and define areas such as the jawline, to what extent though is influenced by things such as weight loss and elasticity of the skin.
It is normal to lose some weight immediately after surgery. For some individuals this can be from the face, for others it can be from other parts of the body. This weight may never return for those that may make lifestyle choices post surgery such as increasing exercise and improving diet.
We therefore are unable to accurately predict how the soft tissues will look after surgery. Be reassured though that moving the facial bones to the optimal position will ensure that facial proportions, and balance are achieved.
