Orthodontics treats the mal-alignment of teeth resulting from either the poor eruption or placement of teeth within the dental arches and/or from an imbalance in the underlying skeletal relationship. There is a point at which the orthodontist can no longer compensate for the underlying bony difference and at this time orthodontics will need to be conducted in conjunction with surgery by highly skilled and trained maxillofacial surgeons.
This treatment may be as simple as the surgical exposure of unerupted teeth to allow disimpaction, or the use of skeletal anchors to achieve dental corrections that could not have been achieved with conventional orthodontics alone. However when jaw discrepancies are larger the surgical movement of the jaw and the facial bones may be required. If so this is normally done after the age of 16 years. Normally braces need to be worn to position the teeth ideally before the surgical procedure as well as to stabilise the dentition following the surgery.
For a limited number of patients as young as 12 years there is also now a procedure called osteogenic distraction of the jaws which can also be used to gain early jaw correction. The technique is also known as IMDO (Inter Molar Distraction Osteogenesis). The bony imbalance will then be addressed in conjunction with orthodontic alignment of the teeth, usually before and after the surgical intervention.
The results achieved can be cosmetically outstanding and have a significant positive effect for the patient. Surgical orthodontics should only be conducted by a team of highly experienced interdisciplinary specialists.