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Jaw Surgery and Dental Implants in Singapore Blog

Dental implants in an underbite patient

underbite_2Rising affluence and awareness among patients in Singapore have led to an increase in demand for specialist procedures such as orthognathic surgery. Underbite deformity, where the lower jaw is disproportionately longer than the upper jaw is possibly the most corrected dentofacial deformity in Singapore today. However, not so a generation ago. Baby boomers, or in the Singapore context, the Merdeka Generation, often did not have the benefit of such services when they were young and many have uncorrected underbite. With advancing age and a lack of proper care in their younger days, total or partial loss of dentition is common. Many seek to replace their missing or decayed teeth with dental implants. In replacing teeth in a patient with an underbite, do we set the teeth in the original cross bite position or do we aim to reconstruct the dentition into an ideal Class I bite?

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Missing Teeth and Jaw Deformity in the older patient

Most dental implants patients are usually older adults who have lost some or all dentition over the course of many years. On the other hand, corrective jaw surgery patients tend to be younger, those in their late teens and twenties. However, there is a group of patients who have dentofacial deformities that require orthognathic surgery but somehow did not get around to doing it when they were younger but in their later years, require dental implants to replace their missing or failing dentition. For such patients, orthognathic surgery may be done in conjunction with dental implants to restore not just a functional dentition but an improvement of facial aesthetics as well.

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Functional indications for corrective jaw surgery

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Corrective jaw surgery is often perceived as cosmetic surgery. Indeed, the cosmetic enhancement is probably the most obvious outcome of the surgery. However, it is primarily a functional correction of a discrepancy in the bite disharmony caused by disproportionate growth of the jaws.

 

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A little bit of orthognathic surgery but not too much

 

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It is quite common in my practice to have patients coming in to ask for jaw surgery to correct what they feel are minor deformities. They often say that they are not seeking major changes and only want a bit of surgery but not too much. Every often, such requests are harder to fulfill than requests for extreme makeovers. Jaw surgery can achieve dramatic changes in facial appearance especially in cases of gross discrepancies of facial bone proportions and symmetry. However, for the patient who says she does not want major changes, is orthognathic surgery suitable?

 

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Medical tourism for corrective jaw surgery in Singapore

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Singapore has a long history as a medical tourism destination. The high standard of healthcare, comparable to the best of America and Europe, has attracted many patients from Asia. Some of the most commonly sort after procedures by medical tourists are cardiology and oncology. Corrective jaw surgery http://www.aestheticjawsurgery.com/orthognathic-surgery-singapore-corrective-jaw-surgery is slowly increasing in demand as well. What is the process of a medical tourist seeking corrective jaw surgery in Singapore?

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Corrective jaw surgery for the middle-age patient

 

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Most patients for corrective jaw surgery are teenagers or young adults. It is often at this age that the patient is aware of the problem and seeks treatment. The motivation for seeking surgery is usually a combination of functional problems and aesthetics. However, increasingly, I am seeing more middle-aged patients. Are these “older” patients suitable for such surgery?

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Do I need to remove the fixation plates after corrective jaw surgery?

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Corrective jaw surgeryis a procedure whereby the jaw bone is cut, detached, moved to a different position and held there with some sort of fixation device. In the past, the fixation device comprised mainly stainless steel wires to tie the jaws in the new position. Today, this is achieved by using plates and screws placed internally to provide a rigid fixation. Some patients are concern about the possibility of setting off metal detectors at the airport while others wonder whether having the metal plates and screws in their body affects their health in the long run. Can these fixation plates and screws be removed? Should they be removed?

 

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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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The perspectives on corrective jaw surgery by patient and parents

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Last night, while driving home, I was listening to BBC on the radio and they were talking about President Obama replying a letter sent by a young girl who wants to pierce her nose against her parents’ wishes. Basically, President Obama told her that she should leave such decision to her parents till she has grown up. I can empathize with both the girl and her parents, as this kind of “conflict” between parent and child plays out in my consultation room regularly.

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