New 3D jaw re-alignment procedure being used by medics in Wolverhampton is s-miles better

Consultants at The Royal Wolverhampton NHS Trust (RWT) have carried out surgery using 3D modelling on around 15 patients with complex dental problems.

These are normally most complex jaw deformities from birth and varied malocclusions – known as ‘bad bites’ – which significantly affect function and aesthetics.

Over the past year, the orthognathic multi-disciplinary team has adopted an approach which uses 3D facial and dental scans, 3D printing of surgical templates and 3D face-morphing software to achieve more accurate outcomes for such patients.

Research evidence and the team’s experience shows there are advantages of using this technique including that it is more precise, reduces the length of inpatient stay and has higher patient satisfaction.

The 3D procedure is suitable for those aged 18 and above – because it cannot be performed on patients whose jaws are still growing – and with a facial deformity, such as a protruding lower jaw and/or incorrectly aligned jaws.

Traditionally, these patients would undergo surgery using two-dimensional facial x-rays, plaster models and lab-made templates to correct the patient’s bite.

This limited the accuracy of the planned surgical movements and consultants could not see the whole face as they were only looking at teeth and bones.

Previously, it could take two operations – one for the jaw and another for the chin – with a six-month delay between the two because of the amount of swelling.

But with the new approach, everything can be done in one procedure and patients return to a normal diet within six weeks of surgery, with wiring of the jaw a thing of the past.

The service is led by Suresh Shetty, consultant in orthodontics and maxillofacial surgery and Jagadish Prabhu, consultant orthodontist, supported by specialist nurses and laboratory technicians.

Mr Prabhu said: “We are proud that our unit can now offer latest cutting-edge techniques in orthognathic care for our patients.

“This hybrid digital care pathway is audited and shows a high satisfaction rate in treated patients – 98 per cent satisfaction.”

Mr Shetty added: “We’ve now had some exceptional results using this technique. Because it’s more precise, the surgical errors are minimised, and patients with severe problems cam be treated to achieve excellent outcomes with high patient satisfaction.”

Under the 3D procedure, a CT scan is done, the 3D models are printed and sent to the laboratory to be adapted by the software, then the consultants have an online discussion to plan the surgery before the templates are created on a 3D structure.

From there, titanium plates are moulded via a 3D format to enable a more sharply defined picture to be created.

Post-surgery, a six-month appointment stabilises the patient’s bite before they are discharged.

Patient Jacob Sawyers, from Wolverhampton, recently benefitted from this procedure, having had his top jaw moved forward, his lower jaw moved back and slightly rotated and another procedure on the chin.

“I’m extremely happy with the result,” said Jacob.

“My bite and asymmetry have been corrected and I’m grateful for the great care I received. I couldn’t have asked for a better result or a better team.”