Why does the combination of double-jaw surgery and Invisalign work so well?

Hello,

This is Yonsei Baro Dental Clinic in Apgujeong, Invisalign.

Today, we’re talking about double-jaw surgery and Invisalign. As I always say, double-jaw surgery can create synergy when combined with Invisalign orthodontic treatment. Whether it is surgery-first or conventional double-jaw surgery, the orthodontic treatment period is usually about one year.

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The patient came to us through a referral from an acquaintance, and because of facial asymmetry, there was an occlusal problem where the midline and the molars on one side were in crossbite.

Even without double-jaw surgery, orthodontic treatment alone would have been enough to align the midline and occlusion, but the patient wanted the overall facial asymmetry corrected as well, so we decided to proceed with double-jaw surgery.

At our clinic, we are connected with oral and maxillofacial surgery specialists who are well known among dentists for their skill in double-jaw surgery. We also guide patients so they can consult several places directly and choose the clinic that suits them best.

After surgery-first, 23.02

This is the bite after surgery-first double-jaw surgery in January 2023. The midline had actually shifted to the opposite side compared with the beginning.

Traditional double-jaw surgery orthodontics follows the standard sequence of pre-surgical orthodontics - double-jaw surgery - post-surgical orthodontics, but nowadays surgery-first is also common, and choosing surgery-first does not necessarily lead to poor orthodontic results. If surgery-first is possible, it is better for the patient to proceed with surgery-first and then start orthodontic treatment afterward. Pre-surgical orthodontics usually progresses in a way that further worsens the malocclusion, so patients often experience significant discomfort during that period, and esthetically things can be unsatisfactory until surgery.

Surgery-first is performed without pre-surgical orthodontics to create the post-surgery bite in advance. Right after surgery, the bite is open like this.

Based on this condition, we took an Invisalign scan and began appliance fabrication. For those wondering about the timeline when double-jaw surgery orthodontics is done with Invisalign, let’s break it down.

January 2023 first visit and surgery-first February 2023 Invisalign appliance ordered Late February 2023 Invisalign treatment started October 2023 remade (additional set) February 2024 remade (additional set) May 2024 treatment completed

Excluding the total two months spent waiting for appliances for the two remakes, the actual time spent wearing the appliances during treatment was 12 months. Let’s look at the treatment process.

This is the condition after wearing the first set completely for 8 months, from February to September.

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We needed to use rubber bands with multiple hooks to stabilize the bite.

The alignment had improved, but we decided to make additional appliances to further improve the midline and molar occlusion. Then, in February 2024, we made one more short additional set to correct the slightly mismatched midline, and finally the treatment was completed in May 2024.

The midline is perfect.

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Alignment is, of course, the foundation,

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and the bite that many people worry about is also good.

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Double-jaw surgery can create synergy when combined with Invisalign orthodontics. The weakness of surgery-first is that the bite opens up because of early contacts. Invisalign, thanks to the RAP commonly seen in post-surgical orthodontic treatment, is more advantageous than wire braces for the intrusion movement of teeth where early contact occurs. In other words, it helps resolve early contact quickly and makes bite stabilization easier.

I hope this was also helpful for patients who need double-jaw surgery and want to proceed with Invisalign orthodontic treatment.

To summarize,

Q. How long does Invisalign treatment take after double-jaw surgery?

A. It varies by case, but you can usually think of it as around one year. In this case as well, the actual period of wearing the appliances was about 12 months.

Q. Does double-jaw surgery improve facial asymmetry?

A. Because it is a treatment that adjusts the position of the jaw bones themselves rather than simply aligning the teeth, you can expect improvements in the facial midline, left-right asymmetry, and lip balance. However, the most important thing is to determine through an accurate diagnosis whether surgery is truly necessary for the case.

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