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Ortho-surgical treatments

ortodonzia-prechirurgica

Ortho-surgical treatments represent a strong point among the excellence of our dental practice. The professionals of the clinic, all highly qualified and constantly updated on the most advanced treatments, coordinate with the maxillofacial surgeon to set up complex treatment plans for patients who, due to alterations of the face or mouth, have to solve aesthetic or functional problems that require repositioning of the skeletal bases as well as orthodontic treatment.

Ortho-surgical treatments: professionalism for complex interventions

This is precisely the case of subjects suffering from skeletal malocclusions which, due to their nature and complexity, cannot be dealt with exclusively at an orthodontic level and therefore require work in synergy between the orthodontist and the maxillofacial surgeon. The first will be responsible for ensuring correct alignment of the teeth while the second will take care of restoring the right relationship to the jaws.

The intervention, conducted in a team, will lead to an optimization of both the dental situation and the aesthetic one. The patient, after a careful medical history and an evaluation and planning by the orthodontist of our clinic, is subjected to a personalized ortho-surgical intervention project that takes into account all the different factors underlying the pathology as well as the needs and expectations of the patient. Together with the surgeon whom you decide to rely on, the various steps of the orthodontic and surgical path are evaluated and any difficulties or contraindications that you might have to face.

The patient is then subjected to a series of tests that allow you to have an exact picture of the situation.

Panoramic radiography to examine the teeth and possible structural anomalies, dental arch impressions to measure the spaces and teleradiography to view the skull in its entirety are among the main non-invasive tests that precede the surgery. CBCT (computerized axial tomography of the skull) will also be prescribed in order to have all the tools to make a three-dimensional diagnosis of the problem and prepare a digitalized treatment plan. The whole process obviously aims at an optimal result both from an aesthetic point of view and from an occlusal and functional one. The fields of intervention of ortho-surgical treatments are different:

Open bite: Anterior open bite occurs when the upper incisors do not make contact with the lower ones and may be due to a skeletal or dental problem. The solution of the problem, when of skeletal origin, is purely surgical since the exclusively orthodontic one would prove to be complicated and unsatisfactory. The cases that can instead be attributed to exclusively dental problems, however, dental extractions, mini screws and fixed equipment allow us to solve the problem without resorting to maxillofacial surgery. The orthodontist will be able to accompany you on the path of understanding and solving your problem.

Prominent or retracted chin: both cases may be attributable to an alteration in the size or abnormal positioning of the upper and/ or mandibular bone. The patient, after an accurate diagnosis, will be directed to the ortho-surgical treatments best suited to his individual case.

Facial asymmetry: naturally the ortho-surgical treatments are not the slight and practically unnoticeable facial asymmetries that affect us all but, on the contrary, those relating to the facial skeleton or related to important lateral deviations of the mandible. The solution we propose, mainly ortho-surgical, is able to solve the problem from all points of view concerned: aesthetic, functional, and occlusal.

Questions and answers:

Can orthodontics change the profile of my chin and jaw?

Yes, in some cases. By changing the position of the teeth it is possible to change the projection of the upper and lower teeth in the face. For any major change you want to achieve, either surgery or extractions must be used. In planning your treatment, your possible desire to change your profile and smile will be taken into consideration: the dentist will explain the dental and aesthetic changes to your smile involved in the proposed treatment and how these changes could affect the appearance of your face and profile.

Will I need surgery before orthodontic treatment?

If you need surgery, it will normally be performed during orthodontic treatment.  Although there are cases where you decide to have surgery before the placement of orthodontic equipment usually if there is a need for arch alignment before surgery, the teeth will be straightened first and then the jaws repositioned through surgery. The completion of the orthodontic treatment for the finishing of the dental positions will follow and then the usual post-orthodontic restraint phase.

How is the surgeon who will perform my surgery chosen?

Once the necessary records have been collected and the ortho-surgical treatment plan has been prepared, the problem of selecting the most suitable surgeon to solve your specific case is faced. You will be given the references of trusted professionals or you can seek advice from surgeons you know. At that point, all the collected material will be submitted to the surgeon and the treatment coordination process will begin between the two professionals, the patient and his family.

How can I imagine how I will change after the surgery?

There are now a series of programs that allow the surgery result to be viewed with an excellent margin of predictability, and which can give the patient a very realistic idea of ​​the final aesthetics, as well as allow the patient himself to be an active part in the choice of the result.

How long do ortho-surgical treatments last?

These treatments, by their nature, are complex and laborious treatments that interface with the work of several professionals and that often make use of multidisciplinary dental treatments. Therefore they require longer times than traditional orthodontic treatments. We recommend to the patient to address in the order of idea of ​​treatments that also require 24-30 months of treatment before reaching the final result.


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The clinical team lead by Guido and Veronica Bracchetti is committed to this work because they love to take on difficult challenges. They are passionate about doing their job well and prioritize precision and details. They are highly motivated and prepared to exceed expectations and achieve excellent results for patients. This often means they face clinical situations and problems which other dentists have not been able to resolve. The goal of the clinical team is to go beyond patients expectations and give them even better results than what they originally requested.

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