05 June 2023

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The antiaging effect of combined orthodontic treatments with orthognathic surgery

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Teeth, like the rest of our body, evolve and change throughout life, so our mouth also shows the signs of aging. Improving the function and health of the mouth are the main objectives of an orthodontic treatment, but most patients recognize that one of the main motivations to undergo orthodontics is to get a more beautiful smile. What few know is that, in addition, some facial aesthetic improvements can also be achieved when the patient undergoes this procedure.

As Dr. Juan Carlos Pérez Varela explained, "with the passage of time the teeth tend to crowd, especially the lower ones, and that is one of the reasons why many adults currently undergo orthodontic treatment to realign them. In some cases for a purely aesthetic reason, and in others because dental crowding is very severe and causes problems of bad occlusion."

Although in general the ideal time to undergo orthodontics is during the growth stage, currently most patients in orthodontic clinics are older. And, from the age of 40, the changes and problems caused by the aging of oral tissues and structures begin to become visible.

Pérez Varela said that "an orthodontic treatment in the hands of a good specialist can achieve a certain anti-aging effect by correcting some of the effects of the passage of time." He said this includes things like lifting the tip of the nose, giving greater projection to the lip and slightly increasing the degree of exposure of the gum.

But the greatest changes in the appearance of the face are achieved not only by orthodontics, because in an adult patient the maxilla cannot be advanced. These changes are achieved with a combined treatment of orthodontics and orthognathic surgery, which manages to correct many of the effects of aging on the face.

Dr. José Ferreras, from the MAEX Clinic of A Coruña and Ferrol, a specialist in oral and maxillofacial surgery, pointed out that "orthognathic surgery or surgery of facial deformities allows to treat, either for functional or aesthetic reasons, those cases in which there are problems of facial harmony, with movements of the facial bones," including the nose, cheekbones, mandible, chin or upper jaw.

Ferreras added that "the facial skeleton is our soft tissue support structure and, therefore, one of the most responsible for facial aesthetics. Any modification we make to the bone bases will have a positive and predictable impact on facial aesthetics."

How is that possible? According to Ferreras, bad positions of the facial bones, which lead to dental malposition, usually condition faces with a feeling of premature aging (in terms of soft tissue supports).

"The changes we make at the level of the facial skeleton by surgery and the inclinations of the teeth by orthodontics, help in a fast way to rejuvenate patients," said Ferreras.

Pérez Varela said that "the objective of any orthodontic treatment is to align, improve occlusion, improve facial and smile aesthetics, improve the airways and even joint problems. However, in many cases of skeletal malocclusions in adult patients, in order to achieve this, we need orthodontics and orthognathic surgery."

He explained that through surgery, clinicians mobilize the bones to place them in their ideal position with respect to the base of the skull.

Without losing sight of the fact that the priority objective is improving a patient's health, Ferreras said that with orthognathic surgery, either by direct effect or by the effect of proportionality, doctors can achieve an impressive aesthetic improvement.

When is orthognathic surgery necessary?  

Pérez Varela said that for a number of adult patients, if the aim is to improve alignment and occlusion, the best option is to choose orthognathic surgery.

On the other hand, he said that today it is more than proven that one of the treatments to improve the airways is to make a bimaxillary advance, that is, to advance the maxilla and the jaw.

The objective of the combined treatments of orthodontics and orthognathic surgery is to achieve the "perfect masticatory function, with well-aligned and level teeth and facial harmony with a well-proportioned face from the aesthetic point of view," explained Ferreras.

The clinicians said that he and his team plan all cases using 3D and facial analysis software, so that the team can foresee what aesthetic changes will take place.

"The use of the facial 3D scanner and a specific software allows us to treat each case in a personalized way with millimeter precision," he said. 

This article appeared originally in Odontologia33.