Medical team

Our team is at your service to guide you through an important path aimed to shift your teeth and jaw to a more balanced position, merging aesthetics with functionality.

Orthognathic surgery?

People who can benefit from orthognathic surgery are those who suffer from mastication problems which cannot be improved with classic orthodontics and those whose dental arches are misplaced because of jaw growth discrepancies.

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Ortognatica Roma – Assunzione di Maria Sant.ma Clinic Center, Via Nomentana 311, 00198 Rome.

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+39 351 504 0117

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Contact the Ortognatica team for tailor-made advice.
Our team of professionals is at your disposal.

The Ortognatica Roma team offers a wide range of interventions to achieve improvements in facial aesthetics and functionality:

ORTHOGNATHIC SURGERY

Surgical operation

Duration of surgery:  about 2 hours Anesthesia: general anesthesia Orthognathic surgery is a procedure that corrects a wide range of maxillofacial anomalies. Moreover, orthognathic surgery not only allows the correct positioning of the dental arches in order to treat the malocclusion of teeth, but it also offers significant aesthetic results combined with functional improvements on breathing, mastication, phonation and posture. This intervention involves the mobilization of maxilla and/or mandible through standard osteotomies and their repositioning according to a correct balance of occlusion and aesthetic. It is performed intraorally and this surgery takes about 2 hours. The hospitalization period lasts 2-3 days after surgery. Intermaxillary fixation is no longer used, except in exceptional cases, because the rigid fixation devices introduced to stabilize osteotomized bones allow early mobilization. The patient is thus able to eat and talk as early as the day following the surgical operation. Swelling reaches its maximum peak after 24-48 hours. The final result can be assessed after 3 or 4 weeks after the surgical operation.

For whom is it indicated?

This procedure can be used to correct all the dentoskeletal class II anomalies (prognathism and micrognathia), receding chin, dentoskeletal class III anomalies (mandibular prognathism), pronounced chin, open bite, facial asymmetry, underbite, crossbite, patients suffering from obstructive sleep apnea syndrome (OSA), patients suffering from “jaw clicking”. The purpose of orthodontic-surgical treatment is to correct dental occlusion in order to improve facial aesthetics and functionality.

What does it correct?

The treatment corrects dental occlusion in order to improve facial aesthetics and functionality.

Surgical operation

Duration of surgery: about 3 hours Anesthesia: general anesthesia Beauty Full Chin was created with the aim of correcting the most severe dento-skeletal class II anomalies, which occur in subjects in which the molars,premolars and canines of the upper arch only hit or even drop down in front of their lower counterparts. This intervention involves the combination of two popular techniques in maxillofacial surgery: Chin Wing genioplasty (mentoplasty) which achieves a complete reshaping of the lower third of the face and the counterclockwise rotation of the maxillomandibular complex. The integrated combination of these treatments not only allows a large mandibular advancement which causes the jaw to move forward as well, but also an interesting increase in mandibular volume, redefining its contour and defining mandibular angles (mandibular contour), emphasizing a surprising three-dimensional effect as well. This is a minimally-invasive surgical technique: the incision is made in the lower edge of the mandible and it does not affect occlusion and teeth and, therefore, no pre- operative phase is necessary. The use of the latest technologies such as the piezoelectric drill guarantees absolute precision, respecting noble tissues such as nerves, responsible for providing sensory innervation to the chin.

For whom is it indicated?

A perfect operation to offer more definition to your facial features. Both women and men can benefit equally from Beauty Full Chin: men can accentuate masculine traits whereas women can finally achieve a perfect facial symmetry.

What does it correct?

This surgery corrects retrognathism which cause the so-called “bird face”, characterized by an underdeveloped mandible and a shortened lower third of the face.

Surgical operation

Duration of surgery: 30-40 minutes Anesthesia: general anesthesia Genioplasty is a cosmetic surgical procedure used to reshape the chin. It consists of performing a horizontal osteotomy of the mandible. It is a helpful surgical technique that is primarily performed to correct chin deformities both in horizontal and vertical facial planes (excessive chin length or shortness). Genioplasty has a big advantage compared to the use of prosthetic implants, that is the great versatility offered to the surgeon. In details, the osteotomized mandibular symphysis provides vascularized materials that can be manipulated in a variety of ways such as reducing or increasing chin length as well as augmenting anterior chin projection. Despite the advantage of not using prosthetic material, this is a more invasive procedure compared to a chin implant.

For whom is it indicated?

Subjects with underdeveloped chin (receding chin, weak chin, bird face), subjects with overdeveloped chin (pronounced chin, protruding chin) with a proper dental occlusion.

What does it correct?

This intervention only improves the aesthetic appearance of the chin. It does not intervene on a possible dental malocclusion.

Surgical operation

Duration of surgery: about 2 hours Anesthesia: general anesthesia The surgical correction of an abnormal upper jaw development is recommended if the gingival smile is attributable to this skeletal alteration. The LeFort 1 osteotomy consists of a horizontal incision above the dental arch and under the nasal pyramid which allows to remove the extra bone. The remaining maxilla is nestled on the remaining bone and thus stabilized with titanium plates and screws permanently placed without removal surgery. Stabilization takes place in the internal part and is therefore invisible. By removing “a slice” of the maxilla, the mandible is no longer aligned with the upper part; this misalignment automatically causes dental malocclusion. For this reason, when a orthognatic surgical procedure of this kind is performed, the surgeon also works on the maxilla so that the opening and closing of the mouth is properly restored.

For whom is it indicated?

Subjects with an excessive gingival exposure during smile.

What does it correct?

Gummy smile or gingival smile or “horse smile”.

Surgical operation

Duration of surgery: about 2 hours Anesthesia: general anesthesia Chin Wing genioplasty is a surgical procedure that aims to mobilize the entire lower mandibular border. In practical terms, it is a technical refinement of genioplasty that extends the osteotomy posteriorly to the mandibular posterior border underneath the mandibular canal. The segment thus mobilized can be brought into the desired position: it can be brought forward or even transversely expanded in order to better define the mandibular angles.

For whom is it indicated?

Subjects who want to have more defined and wide mandibular angles.

What does it correct?

Form and position of angles, form and position of chin.

Surgical operation

Intervention Duration of surgery: 40 minutes Anesthesia: general anesthesia Contrary to popular belief, zygomatic implants can lead to natural-looking results, if correctly used. Our implants are custom-made which means they are designed and subsequently customized based on the patient’s desired cheekbone geometry. Implant realization is carried out after a 3D facial study which takes into account not only the percentage of the zygomatic region projection deficit but also other facial components (nose, eyes, chin) that influence facial harmony. It is therefore important to analyse whether malar hypoplasia is isolated or also associated with aging eyelids or cheekbones, or, especially at a young age, whether it is to be framed in more complex pathologies. In addition, it is equally important to evaluate if the problem is related to a malposition of the skeleton or a simple underdevelopment. The surgical technique used to increase the cheekbones through the use of implants involves a small incision (1,5 or 2 cm) inside the mouth, the creation of a pocket above the bone structure in the area that we intend to raise and the subsequent insertion of the zygomatic implants. When this cosmetic surgery intervention is completed, the surgeon performs a suture in order to hold limbs together after the incision.

For whom is it indicated?

Subjects suffering from a zygomatic region projection deficit.

What does it correct?

This treatment will provide you with well- defined cheekbones, providing an overall better personality to your face.

AESTHETIC FACE SURGERY/MEDICINE

Surgical operation

Duration of treatment: from 15 to 30 minutes Anesthesia: no anesthesia or at most anesthetic cream. Mandibular contouring is an aesthetic medicine technique performed with hyaluronic acid-based fillers. This technique involves reshaping of face contours in order to provide a softer, more feminine appearance. This can be helpful for several problems such as a definite square- shaped face or in case of an abnormal masseter development which is located between the cheekbone and the jaw. Mandibular contouring can also be very useful to solve aesthetic dental problems related to malocclusion of teeth or inadequate mastication that over time can compromise the appearance of the face. Moreover, the intervention can also be performed to achieve an ovoid and slender facial contour or a more triangular profile with prominent cheekbones. Finally, contouring can also be a valid integration support to orthognathic surgery in order to solve small residual defects or not very noticeable asymmetries. This painless aesthetic treatment is based on hyaluronic acid, a totally natural and safe substance that is injected in the dermis with a very thin needle. Immediately after the treatment, there may be slight reactions like redness, swelling, tenderness, itching and bruising. These reactions usually resolve spontaneously in a few hours.

For whom is it indicated?

Subjects who want to redefine the zygomatic and the mandibular angle without undergoing surgery.

Cosa corregge

The treatment corrects dental occlusion in order to improve facial aesthetics and functionality.

Surgical operation

Duration of treatment: 30 minutes Anesthesia: local anesthesia Through a small incision in the natural crease that we all have between the nose and the upper lip, a small portion of skin and subcutis is removed and the upper lip can then be pulled upwards, raising its edge. In this way, the vermillion, which is the red part of the lip, becomes higher and more evident and the natural border of the lips can thus be modified, changing the shape of the cupid’s bow. This procedure helps patients achieve more plump and full lips both frontally and in profile.

For whom is it indicated?

This treatment is a great solution for people whose lips are uneven, asymmetrical or simply too thin.

ENDOSCOPIC NASOLACRIMAL SURGERY

Surgical operation

Duration of surgery: 60 minutes Anesthesia: general anesthesia in day hospital Functional endoscopic sinus surgery (FESS) is used to restore normal physiological conditions of nose and related accessory cavities (paranasal sinuses). The most suitable candidates for this procedure have recurrent acute or chronic infective sinusitis with or without polyps. Functional endoscopic sinus surgery (FESS) is performed using microsurgical instruments, fiberoptic endoscopes, cameras and monitors. It is currently a minimally invasive, safe procedure with short recovery times and less discomfort for the patient than in the past. The goal of this procedure is to restore sinus ventilation and normal function, allowing the removal of nasal polyps and/or infected secretions accumulated in the paranasal cavities (sinusitis). The priority is therefore to restore the natural function without the appearance of external and visible scars on the face. The hospitalization period generally lasts 1 day. After surgery, soft sponge tampons are inserted into the nose and removed a few days after. In the months following surgery, the patient will be followed in our centre thanks to periodic endoscopic controls.

For whom is it indicated?

For all people suffering from chronic sinusitis and nasal polyposis.

What does it correct?

It is a useful technique to restore proper paranasal sinuses ventilation and facilitate the drainage of secretions through the nose. In chronic sinusitis, nasal secretions remain trapped in the paranasal sinuses thus becoming perennially infected: the inflammation of the narrow airways through which nasal secretions pass causes the paranasal sinuses to be unable to adequately drain their contents. The intervention can therefore be resolutive in cases of chronic sinusitis or in the presence of nasal polyps.

Surgical operation

Duration of surgery: 45-60 minutes Anesthesia: local anesthesia The chronic nasolacrimal duct obstruction leads to inflammation or infection of the lacrimal sac: the endoscopic surgery of the tear ducts is a new and advanced technique to solve the problems connected with epiphora, that is a continue and persistent lacrimation. Through the use of an innovative technology which takes advantages of fiber optics and microsurgical instrumentation, the surgeon can clearly and precisely visualize any obstructive problems in the tear ducts, recanalizing them. This method offers multiple advantages over traditional open surgery in terms of surgical precision, surgical duration, safe results and absence of external scars. The operation can be performed in adults with a full anesthesia and in children with the use of light total sedation.

For whom is it indicated?

For all people suffering from epiphora (excessive lacrimation) and congenital obstruction of the nasolacrimal duct: tears, unpleasant ocular secretions, redness, inflammation and dangerous blurred vision, especially when driving.

Surgical operation

Duration of surgery: 40/50 minutes Anesthesia: general anesthesia in day hospital, without the use of nasal tampons. The nasal septum is the dividing wall that runs down the middle of the nose, separating the two nasal cavities, each of which ends in a nostril. Septoplasty is a surgical procedure that corrects the nasal septum position and eliminates its deviations which can have a congenital or traumatic origin. These deviations can cause an obstruction which results in difficulty in breathing. Septal deviations may not be seen externally, that is the nasal septum can be deviated despite a correct nasal pyramid alignment. Similarly, there can be patients with a noticeable deviation of the nose and a straight nasal septum, although this is less common. Therefore, the nasal dorsum does not reveal whether the nasal septum is deviated or not. The procedure involves making a septal mucosal incision, raising the membranes that cover the cartilage and bone of the septum. The nasal septum contains bone in the inferior part and hyaline cartilage in the superior part. The deviated portions of cartilage and bone are removed and the membranes are sewn down onto the cartilage in order to close the incision. If the septum is severely deviated, parts of your nasal septum could be completely removed before reinserting them in the proper position. In case of turbinate hypertrophy, turbinate reduction could be necessary during the operation. Moreover, this operation may involve a combination of rhinoplasty and septoplasty (septorhinoplasty) to improve the appearance of the nose.

For whom is it indicated?

Subjects with breathing difficulties, obstructive sleep apnea syndrome, snoring and other problems related to the deviated nasal septum.

What does it correct?

Septoplasty is a surgery used to correct a deviated septum, restoring proper nasal breathing.

Surgical operation

Anesthesia: general anesthesia in day hospital, without the use of nasal tampons. Only nasal surgery can correct nasal septal perforations. The operation requires general anesthesia. There are several surgical techniques depending on each case. In cases of small perforations (less than 1 cm in diameter), local flaps may be sutured in order to repair the perforation. In cases of perforations up to 2 cm in diameter, we use a mucosal pedicled endonasal flap to repair the defect. In cases of larger septal perforations, a composite graft of the auricular cartilage and the temporalis muscle fascia is used endonasally and/or through or an open procedure with microsurgical suturing. Fiberoptic video endoscopy is always used in surgery. Surgical closure of nasal septal perforation is not 100% effective for several reasons. For example, there could be retraction or graft failure or the persistence of the original pathology which caused perforation (mucosal atrophy, cocaine use, autoimmunity, etc.). In these cases, the intervention might not be effective and a new posterior perforation could occur.

For whom is it indicated?

Subjects with a nasal septal perforation for different reasons.

What does it correct?

The operation corrects nasal septal perforation, restoring proper nasal breathing.

Surgical operation

Duration of surgery: 30 minutes Anesthesia: anesthetic spray Turbinoplasty is indicated when other conservative approaches do not achieve satisfactory results and do not provide good ventilation. For turbinate decongestion, our team uses the innovative method of radiofrequency, an outpatient minimally invasive approach performed with an anesthetic spray. In order to perform this procedure, the physician administers a local anesthetic and decongests the turbinates using a micromaniple: the high-frequency electromagnetic waves emitted by the machine cause a resonance between the cells of the mucous membrane tissue vaporizing them and thus reducing the volume of hypertrophic turbinates. Inferior turbinate reduction is painless, there is no bleeding and there is no need to use bothersome post-operative tampons; the patient can therefore resume his daily life the next day after surgery. In the following days, some localized scabs may appear, which will be easily treated thanks to the program of washings and dressings prescribed by our team. The results can be seen after twenty/thirty days and are long-lasting. Radiofrequency is considered a “cold” method because it operates at a temperature between 40° and 70°: a “biosurgery” technique that preserves the function of the tissues involved without damaging them. An innovative technique that leads to very satisfactory results: breathing has never been so easy!

For whom is it indicated?

For all people suffering from turbinate hypertrophy, a constant inflammatory state that causes a persistent increase in the volume of turbinates and a reduction of the amount of free space in the nose for airflow, causing breathing problems.

What does it correct?

This intervention corrects a persistent increase in the volume of the turbinates. If turbinate hypertrophy is left untreated, symptoms may worsen. Breathing through the nose can become difficult and can result in a decreasing sleep quality with consequent snoring and obstructive sleep apnea syndrome (osas). Moreover, it increases the likelihood of frequent sinus infections, which can create discomfort in daily life. The most common complications include chronic sinusitis, recurrent or chronic pharyngitis, nasal polyps, otitis media or recurrent serum mucous.

Surgical operation

Duration of surgery: 45-60 minutes Anesthesia: general anesthesia Uvulopalatopharyngoplasty (UPPP) is a procedure that removes excess tissue in the soft palate and, if necessary, in the nasopharynx areas, in order to make the airway wider. This can allow air to move through the throat more easily and thus reduce severity of obstructive sleep apnea syndrome (OSAS). The tissues that are removed may include: The uvula, that is the soft flap of tissue that hangs down at the back of the mouth; Part of the palate (soft palate); Excess tissue from throat, tonsils and adenoids; An enlarged tongue is an important factor in sleep apnea; the surgeon may remove a small part of the tongue. A continuous positive airway pressure therapy (CPAP) could be necessary after the surgical procedure. CPAP therapy utilizes machines specifically designed to deliver a flow of constant pressure which can help a person who has obstructive sleep apnea syndrome (OSAS) breathe more easily during sleep. Some analgesics (painkillers) can relax throat muscles. It may be necessary to avoid these medications after the surgical intervention in order to reduce the chances of airway narrowing and causing apnea episodes.

For whom is it indicated?

For patients with excess tissue (both soft palate and nasopharynx) blocking the airway. This procedure is also indicated for all people who do not want to or cannot use CPAP or who do not find benefit from using this device for sleep apnea.

What does it correct?

The intervention corrects and reduces obstructive sleep apnea, eliminating snoring.

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