Overview

What is jaw (orthognathic) surgery?

Jaw surgery, or orthognathic surgery, fixes misalignment between the upper and lower jaws. Misalignment can make eating and speaking difficult. The process involves several stages: first, you get braces to prepare your teeth, then undergo surgery to realign your jaws, and finally, you might need more braces during the recovery period. The entire treatment can take between two to three years.

How do people develop jawbone problems?

Generally speaking, Jaw bone issues typically fall into two categories: those present from birth (congenital) or those that develop later due to injuries or other medical conditions affecting the jaw.

What are examples of congenital jaw problems?

Congenital jaw problems range from specific issues like overbites to broader syndromes such as Treacher-Collins. Here are more examples of such problems:

• Crossbite: Occurs when some of the lower teeth are positioned in front of the upper teeth.
• Underbite: Where the lower teeth extend further than the upper teeth.
• Open bite: This happens when the teeth are out of alignment with the mouth closed.
• Cleft lip and palate: A condition where the lip and/or palate did not develop properly.
• Pierre Robin sequence: A condition where infants have a smaller lower jaw, which can make eating and breathing challenging.

What are some examples of jaw issues resulting from injuries or medical conditions?

• Facial Fractures: Jaw fractures can affect the lower jaw (mandible) from impacts and the upper jaw (maxilla) from falls or accidents.
• Cysts and Tumors: Jaw surgery might be necessary to address cysts, tumors, or issues from radiation exposure.
• Obstructive Sleep Apnea (OSA): OSA happens when airway tissues block breathing during sleep. Maxillomandibular advancement (MMA) Surgery can be used to resolve this issue.
• Temporomandibular Joint Disorders (TMJ): TMJ issues often arise from an improper bite, where the upper and lower teeth don’t align correctly.
• Growth Disturbances: Excess growth hormone can lead to abnormal enlargement of jaw tissues, causing changes in the size of your upper and/or lower jaw.

What should I consider before undergoing jaw surgery?

Before jaw surgery, understand the goals and process. Share your desired results with your healthcare team. The procedure, a long-term commitment, involves pre-surgery braces, surgery, recovery, and post-surgery braces.

What happens before this procedure?

Preparing for jaw surgery involves several important steps to ensure precise planning. Our doctor will gather crucial information through:

• X-rays to view the bone structure.
• CT scans for detailed images of your jaw.
• Photographs of your teeth and jaw for visual reference.
• Dental impressions to create a 3D model of your teeth.

Additionally, they may scan your teeth for further details.

Will I need an orthodontic treatment before my jaw surgery?

Yes, your orthodontist may remove teeth and fit braces to prepare for jaw surgery. You’ll typically wear braces for about a year before and after the surgery.

What should I do to prepare for jaw surgery?

Your diet will likely be restricted to liquids and soft foods after surgery, so stock up on soups, milk, nutritional drinks, and blendable fruits or veggies. Also, discuss anesthesia preparation with your healthcare provider before the procedure.

What are the different types of jaw surgery?

Jaw surgery addresses issues where your jaws are misaligned, causing your facial features to look uneven. There are three main types:

• Maxillary Osteotomy: This corrects problems with your upper jaw, whether it protrudes or recedes too much, and can also fix issues like open bite and cross-bite.
• Mandibular Osteotomy: This targets issues with the lower jaw, adjusting it if it’s too far forward or backward.
• Double Jaw Surgery: This is used when both the upper and lower jaws need adjustment to address complex alignment problems.

What happens after jaw surgery?

You might need to stay in the hospital for one to four days after surgery for observation. Here’s what to expect during your hospital stay and recovery:

• Plastic Splint: You’ll have a splint in your mouth to help your muscles adapt to the new jaw position. Wear it except when eating or brushing your teeth.
• Swelling: Expect significant facial swelling. Sleep with your head elevated and use prescribed medication to manage swelling and pain.
• Ice Packs: Apply ice packs to your face for 20 minutes at a time, with 10-minute breaks, during the first 24 hours.
• Liquid Diet: Start a liquid diet, which you’ll follow for several weeks.
• Communication: The swelling and splint might make speaking difficult. If you find it hard to communicate, inform your healthcare provider for suggestions.
• Splint Removal: The splint will be taken out about eight months after surgery.
• Braces and Retainers: With braces, you’ll wear them for six to nine months. After removal, use full-time retainers for a year, then part-time.

Risks/Benefits 

What are the advantages of this procedure?

Jaw surgery can correct issues when your upper and lower jaws don’t align properly. It’s often considered when orthodontic treatments alone haven’t resolved the problem.

What risks or complications might arise from jaw surgery?

As with any major surgery, jaw surgery carries certain risks. Some are general surgical risks, like complications from anesthesia, bleeding, or infection. There are also risks specific to jaw surgery, including:

• Damage to your teeth.
• Inadequate healing of the bones.
• Issues with your jaw joint.
• Difficulty opening your mouth as wide as desired.
• Persistent numbness in your cheeks or lower lip.
• Further surgery may be required if the initial procedure doesn’t fully resolve your issues.
• Possible return of the original bite problem.
• Scarring.

Recovery & Outlook

What is the recovery time after jaw surgery?

Recovery from jaw surgery varies but generally requires a few weeks of rest. Light activities may be possible; consult your healthcare provider.

When should I see my healthcare provider?

ead to the emergency room if you:

• Experience sudden shortness of breath.
• Develop a fever over 100.4°F (38.3°C).
• Check if your pain is worsening rather than improving.
• See a green, foul-smelling discharge from your surgery site, especially if it appears dark red or feels warm.
• Have ongoing vomiting or diarrhea.
• Observe that the stitches on your incisions seem to be coming apart.
• Notice heavier bleeding than anticipated.