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Oral Surgery/Pre-surgical bite registration

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Question
Greetings! My wife is a candidate for orthognathic surgery. I am curious to find out what is the importance of the pre-surgical bite registration and how this will be used in making the surgical splint and surgical planning via computer modeling. It seems that my wife has a dual bite and I would like to understand more about this and how this dual bite (choosing one type of bite over the another type of bite) will affect the mock surgery, surgical planning,  surgical splint, and the overall result of the surgery. What does the bite registration produce or how is it important in ultimately helping a surgeon with the surgery. Another concern of mine is that if the position of the bite is not chosen properly (via pre-surgical bite registration), this can influence negatively the position/relationship between maxilla and mandible, TMJ position and functionality post surgery?

Answer
Aubrey -  The presurgical bite registration is very important.  The best way I can describe its importance is that it helps to establish a proper bite similar to a building's foundation.  The way the upper and lower jaw come together is critical to create a successful and "structurally" sound bite and stable bones of the face after the surgery.    

A dual bite is a relationship of the lower jaw to the upper jaw through the joint.  When dual there are two positions found to be stable.  A single bite is very important.  A dual bite eliminates a stable position that the jaw muscles need.  If there is not a stable bite, the jaw muscles will eventually go into spasm.  

The proper position of the bite is very important and it is why orthodontics is done to allow the upper and lower jaw teeth fit together stable.  That is why the presurgical bite registration is important to make sure that a single bite relationship would be established for stability from the surgery.  With a single relationship, the surgeon should be able to seat the lower jaw into the TMJ joint stable and allow a good functioning of the jaw.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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