Orthognathic Surgery First-Surgery Orthodontic Review: Invisalign Orthodontics

Hello,

The combination of orthognathic surgery and Invisalign clear aligners offers good results and many advantages in terms of treatment time as well.

This time, I will show the Invisalign orthodontic process for a case that required orthognathic surgery not only because of asymmetry but also because of a prognathic jaw, when surgery was performed first.

Orthognathic Surgery Invisalign First-Surgery Orthodontic Review

23.01

A patient visited for orthognathic surgery orthodontic treatment.

As the dental midline is deviated, there is jaw asymmetry.

23.01

Not only the molars but also the front teeth were in a reverse bite, so the patient was diagnosed with skeletal Class III malocclusion.

The patient had already decided to proceed with surgery first at the orthognathic surgery hospital, so they came in for post-surgery orthodontic treatment with Invisalign.

Whether a case is suitable for surgery first requires the judgment of both the orthognathic surgery doctor and the orthodontist.

This is a photo taken one month after orthognathic surgery performed first.

23.02

This patient shows severe open bite.

Was the surgery done incorrectly?

No. This is because they are in the physical therapy period.

A process of stabilizing the jaw position by attaching rubber bands to the screws implanted in the gums is necessary.

Depending on the surgical method, whether IVRO or SSRO, and depending on the surgical outcome, this process may take several months.

After the jaw position was stabilized, we decided to start orthodontic treatment, and physical therapy continued for a few more months.

23.05

After about three months of physical therapy, the patient returned, and the open bite had significantly improved.

The remaining open bite now needs to be corrected through orthodontic treatment.

23.05

At this stage, an Invisalign scan is also taken and appliance fabrication begins.

After waiting a month and a half for appliance fabrication and delivery, the first aligner was started in June 2023.

A total of 23 aligners were made for the first set, and this is the result after wearing all of them over five months.

23.10

The midline is aligned, and the open bite has been resolved.

23.10

However, there were still some unsatisfactory points in the bite and alignment, so remaking was started.

23.11

A month is also needed for appliance fabrication during remaking.

After waiting one month, the second set of aligners was received and started.

23.11

In the second set, rubber band use was also prescribed to match the molar bite relationship.

This July, the treatment was finally completed.

24.07

This shows the fixed wire retainer as well.

23.01~24.07

23.01~24.07

The combination of Invisalign clear aligners and orthognathic surgery produces good results.

For the orthodontic period, you can generally think of about one year.

For this patient as well, it took a total of 1 year and 1 month from June 2023, when the first aligner was worn, to July 2024.

If you exclude the one month spent waiting for the aligners to be remade in the middle, the actual treatment period was one year.

I hope this post was helpful for those who want orthognathic surgery but find traditional braces burdensome,

and I will end here.

Thank you.