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Jaw Surgery and Dental Implants in Singapore Blog

Who calls the shots in orthognathic surgery- orthodontist or surgeon?

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Many conditions require multi-disciplinary management. For example, ischemic heart disease may require the expertise of the cardiologist and the cardiothoracic surgeon. In the same, way, dentofacial deformities require the expertise of the orthodontist and the maxillofacial surgeon. The best outcome is achieved when surgical and non-surgical options are considered, balancing the treatment objectives and the risks involved. However, very often, the treatment plan depends on who is primarily in charge of the treatment planning.

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Is orthognathic surgery considered as plastic surgery in Singapore?

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Orthognathic surgeryis the surgical correction of dentofacial deformities. Orthognathic is derived from two words, “ortho”, which means to straighten and “gnathic”, which means jaw. It refers to the “straightening” of the jaws, i.e. changing the form of the jaws. Plastic surgery, contrary to popular perception, does not necessarily mean cosmetic surgery. “Plastic” means changing the form. And so it is any surgery that changes the appearance/shape or a part of the body. With such a definition, corrective jaw surgery in Singapore be considered as plastic surgery. But is it cosmetic surgery?

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Dentofacial aesthetics for the older patient

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A colleague once told me this story about a patient of his. An elderly gentleman came in with several badly decayed front teeth. The teeth were quite rotten, discolored and malaligned. He thought to himself that he could be a hero to this patient because no matter what he did, he would have vastly improved the function and aesthetics of his teeth. However, as he commence the restorative work, he discovered that restoring function was the easy part but aesthetics is a different ball game, the profile of the patient notwithstanding. The patient was exacting in his demand for aesthetics, no different from a younger patient. A mutual friend who was in the car industry then said that the guy who drives an old beat up car to a car dealership to collect his new car will not accept a single scratch on the new car. How true.

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Does facial asymmetry need corrective jaw surgery?

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Once of the features we look for when doing a facial aesthetic assessment is symmetry. It is generally believed that symmetry is good and is essential for aesthetics. However, the human face is never perfectly symmetrical. In fact, the human body is not symmetrical. The right side of the body is not a mirror image of the left. The differences between the right and left side give a face its unique character. It is only when the asymmetry becomes the overwhelming feature of the face that it becomes unaesthetic. How do we draw the line?

 

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What cosmetic jaw surgery do I need?

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The advent of the internet has done much to decrease the information asymmetry between patient and doctor. Having the information is one thing but joining the dots to complete a picture is another. The wealth of information that is freely available on the web can be overwhelming. Cosmetic jaw surgery patients are generally youngish and most would have done some homework prior to coming in for a consultation. Once in a while I get some who are medical website junkies who scour the net for information and form their own diagnosis. They email in their own diagnosis and the treatment that they want and ask for a quotation. Most of the time, I either do not reply or simply tell them that I can’t comment until after a physical examination. Fortunately, the vast majority of patients are not like that. Most patients will ask the question, “What cosmetic jaw surgery do I need?”

 

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Should I have a chin implant or a genioplasty?

 

bigstock-Beautiful-Young-Woman-Teeth-Cl-49719305.jpgChange of facial contour can be done by either shifting the facial bones around, i.e. orthognathic surgery, or by adding facial implants. What is actually done for a particular patient depends very much on which surgeon she sees. In general, in Singapore, most plastic surgeons tend to opt for the chin implant while oral maxillofacial surgeons tend to gravitate towards genioplasty. So, which is the better option?

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Creating the V Shape Face by jaw contouring surgery in Singapore

bigstock-Beautiful-Young-Smiling-Woman-102800567.jpgTwenty-four years ago, when I was preparing my Master’s thesis, I reviewed a lot of literature on facial norms. I needed to look at what constitute a “normal” face. As it turned out, most of the publications were actually based on aesthetic ideals. Naturally, this is because surgical literature are biased towards surgically enhancing facial proportions and features to achieve an aesthetic outcome. Somehow, “normal” is not what patients who are ready to subject themselves under the knife wanted. In Singapore, we are subjected to chiseled angular facial features of the West and the V-shape face so desired in Asia.

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Can Invisalign be used with Corrective Jaw Surgery in Singapore?

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One of the common bugbears of orthognathic patients is the need to have braces for two years or more. Many of them are young adults with an active social life and having metal tracks in the mouth is not exactly a positive fashion statement. Invisalign, a system of transparent orthodontic aligners generated by computer-aided design, is a revolutionary approach to aligning teeth. It has gain tremendous popularity due to the “invisible” nature of these appliances, eliminating the metal tracks altogether. Can Invisalign be used in orthognathic surgery cases?

 

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Facial contouring with orthognathic surgery in Singapore

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Facial contouring surgery consists of augmentation and reduction of facial bones to change the contours of the face. Augmentation can be achieved by using implants. These implants are screwed onto the underlying facial bone to increase the projection of the face where it is deficient, e.g. a chin implant. Reduction can be achieved by trimming off prominent bony contours with a saw or drill. Orthognathic surgery can be used to achieve both augmentative and reductive results that are more natural and long lasting.

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Planning for corrective jaw surgery for underbite deformity

underbite_photo.pngUnderbite deformity in Singapore is the most commonly correct dentofacial deformity. With advances in understanding of the healing process and orthodontic movement of teeth, it is usually treated in a surgery-first approach today. This is in contrast with the old practice of going through a year or two of pre-surgical orthodontics to prepare the teeth for surgery. The use of CT scans and 3D modeling software enable both surgeon and patient to visualize the facial aesthetic treatment outcome that is desired. Let’s take a look at a typical case of surgical correction of an underbite deformity.

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