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Old 09-12-2010, 06:51 PM   #1
King Sirex
Join Date: Aug 2002
Location: Toronto
Posts: 9,846
Mandibular Advancement Surgery?

Has anyone had this procedure done?

I recently got braces (in May) and my treatment so far is coming along great. My Orthodontis however recommended that I would be a suitable candidate for this procedure and that it would significantly reduce my ortho treatment time by possible 8 months.

My ortho told me that its basically plastic surgery and that I would not need to have jaw wired shut. all they do is put these plastic spacer like things to just push it forward.. That the procedure they would use on me is done in as little as 40 minutes and you can go right back to normal eating and chewing. Silly me I didn't ask about the cost of the procedure. So I haven't yet called for a consultation with this plastic surgeon, but just wanted to know if anyone here has done something similar or knows what I am referring too? Roughly how much it cost them, and if it did reduce their ortho treatment time?
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Old 09-12-2010, 08:38 PM   #2
6th Gear Member
Join Date: Apr 2002
Location: Toronto
Posts: 7,720

There are people with different types of orthodontic problems. Some people have problems with their teeth (crowding, spacing etc.) and others like you have problems with the way their jaws line up. In your case, if your orthodontist has recommended Mandibular advancement surgery, then your lower jaw is too small and too far behind your upper jaw. This is called a Skeletal Class II relationship of your jaws.

The reason you need a mandibular advancement, is because you fall into a category where your upper jaw is too far forward from your lower jaw, and the discrepancy between the two is too far to fix with braces alone. In people with a mild to moderate Skeletal Class II problem you can fix the problem with either braces alone, or braces in conjunction with removal of permanent teeth, so you can slide upper and lower teeth together to make the teeth fit properly even though the jaws are not normal.

The procedure isn't really plastic surgery. Here is what is going to happen if you decide to go through with the surgery.

If you watch the video, at about 3 seconds, you see the Skeletal Class II pattern (Lower jaw too far back compared to your upper jaw). Braces are then placed, the teeth are aligned, and the mandibular advancement surgery is done.

All cuts are made intra-orally (inside the mouth), and cuts are made to the inside and outside surface of the lower jaw. The two pieces of the lower jaw are delicately separated and the lower jaw is carefully slid forward into the proper position. If you look at the ~ 23 second mark, you can notice the beneficial soft tissue change of the chin and lower lip. Your profile improves nicely.

At the 28 second mark, a tiny titanium plate and small screws are placed. This is called rigid fixation. The two pieces of bone are fixated together, which is why people arent wired shut for months in the way they used to be in the past. You are opening and closing and talking normally within a few days, the soft tissue swelling from the surgery is usually gone in 2-4 weeks.

The person who does this procedure is not a plastic surgeon. Its another dental specialist, an Oral Surgeon. The surgery should be covered by OHIP if the problem is functional in nature (ie you cant eat, chew, and talk properly), but the Oral surgeon will know for sure. If you are doing the surgery because you dont like the look of your lower jaw(ie an esthetic reason), then you would probably have to pay for it. I believe there is a 1-2000 hospital fee stay since you do stay for 1 night in the hospital after the surgery, but again your oral surgeon will let you know for sure.

The only part of the procedure that is considered to be esthetic is if they decide to do a genioplasty along with the mandibular advancement surgery. Its not always necessary, but in some cases it does provide ideal esthetics.
Here is a genioplasty

Surgery is usually the better option if you have a severe class II problem. But no matter what option you do decide to choose, you made a good choice in getting orthodontic treatment.
If you have any other questions let me know....who is your orthodontist btw?
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Old 09-12-2010, 10:35 PM   #3
King Sirex
Join Date: Aug 2002
Location: Toronto
Posts: 9,846
hmm, I should have asked more questions about it because it didn't sound that intense when he explained it to me.... do you know roughly how much it costs, and if insurance usualy covers that procedure?

By the way my ortho is Dr. John Voudoris.

He recommended Dr. Claudio Tocchio for the surgery.

Last edited by sirex; 09-12-2010 at 10:52 PM.
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