The maxillary bone and the mandible, known as the upper and lower jaw, respectively, are meant to engage flawlessly and be in balance. However, this is not always the case for everyone.
Occasionally, the upper or lower jaw is positioned more forward or backward than it should be. This causes a facial aesthetic defect that can be highly noticeable. Moreover, it can also cause issues when biting and TMD (Temporomandibular Joint Disorder).
Fortunately, an oral or maxillofacial surgeon can fix this complex issue through corrective jaw surgery. This procedure allows the dentist to reposition the bone in the desired place and even change its length or size to solve the aesthetic defect. Furthermore, it can also help the lower and upper teeth to engage appropriately.
In this article, we’ll explain what corrective jaw surgery is, how it is performed, and the risks associated with the procedure.
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What is corrective jaw surgery?
A corrective jaw surgery, commonly known as orthognathic surgery, is a specialized and invasive surgical procedure. This surgery is only performed in cases that involve the position of the maxillary and mandible bones. These bone defects can make the jaw look longer or shorter than it should. Therefore, it results in facial asymmetry.
The dentist or surgeon completely cuts and separates the affected bone to perform corrective jaw surgery. Afterward, the bone is shaved or repositioned in the proper position.
Usually, these bone issues can also involve severe malocclusion. As a result, in these cases, the upper and lower teeth might not even engage properly.
In most cases, these bone defects are developed at birth and are congenital. Nonetheless, a severe jaw injury during childhood can interfere with bone development and result in a structural defect.
Due to the nature of orthognathic problems, they tend to be highly noticeable. Nonetheless, the teeth misalignment associated with them might only be observed when the person smiles or speaks. Some of the common malocclusions include:
Although corrective jaw surgery can fix the bone position issue, traditional orthodontic treatment is often necessary to solve the teeth misalignment. Moreover, in most cases, the patient might need to undergo treatment with braces before and after the surgery.
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How is corrective jaw surgery performed?
Corrective jaw surgery is a highly invasive procedure that involves extensive planning to achieve a successful result.
Before surgery, the dentist uses X-rays and CT scans to evaluate the bone and important facial structures. This allows the dentist to plan the surgery safely and reduces the risk of complications and unexpected inconveniences.
Due to the nature of this surgery, the procedure is performed in a hospital setup under general anesthesia. This prevents any pain during the surgery and allows the surgeon to be prepared if an issue appears, allowing him to solve it immediately.
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The surgery frequently involves several steps:
Initial incision
After the patient is anesthetized, the doctor performs an incision on the gums. This incision reveals the underlying bone and allows the surgeon to work on it.
Bone separation
First, the surgeon cuts and separates the bone using specialized tools to move it as a single piece. Once separated, the surgeon can move it down, up, forward, or backward. Additionally, the surgeon can shave it to remove bone excesses.
Bone fixation
Once the bone is aligned and placed in the appropriate position, the surgeon fixes it with plates and screws. This allows it to remain in place as it heals.
Sutures
The last step during surgery is to stitch the gums back into their original position. Since the incisions are done inside the mouth, no visible scars or stitches are left after the procedure. Nonetheless, in some rare occasions, the surgeon might need to make an incision outside the mouth.
Also, the surgeon may provide the patient with a protective splint after the surgery.
Finally, after surgery, people often need orthodontic treatment to finish aligning the teeth into the desired position.
Types of corrective jaw surgery
Since different bones can be involved in the surgery, the procedure is classified based on which bone receives it.
Maxillary osteotomy
This surgery changes the position or shape of the upper jaw bone. It moves the entire maxillary bone, including the teeth and mouth palate.
Mandibular osteotomy
This surgery changes the position or shape of the lower jawbone. Nonetheless, the TMJ (Temporomandibular Joint) is left untouched.
Bimaxillary osteotomy
In this case, both maxillary bones: the upper and lower jaw, are operated on simultaneously.
Genioplasty
This is a specific type of corrective jaw surgery. Genioplasty changes the position and shape of the chin. Unlike other corrective jaw surgeries, this procedure doesn’t fix any malocclusion and is only performed to improve the person’s appearance.
Benefits of corrective jaw surgery
Corrective jaw surgery offers a wide variety of benefits, such as:
Aesthetic improvement
Corrective jaw surgery drastically changes and improves your facial features. Often, jaw bone defects result in facial imbalance and asymmetry.
Malocclusion improvement
This procedure allows the dentist to solve severe teeth misalignment or malocclusions that can’t be fixed through orthodontic treatment alone. Moreover, it helps to adjust the bite.
TMJ improvement
The severe malocclusion caused by bone issues can result in TMJ disorder and pain. Therefore, correcting this issue can improve the joint condition and ease the pain and discomfort.
Solve breathing problems
In some cases, breathing issues such as obstructive sleep apnea, snoring, and mouth breathing are caused by severe malocclusion. Thereby, corrective jaw surgery could also fix these issues.
Improved self-esteem
The person might feel better and more comfortable with the new facial appearance.
Recovery after corrective jaw surgery
Since this surgery is highly invasive, it takes several weeks or months to heal. Furthermore, the patients are often asked to stay in the hospital for around 4 days after surgery. This way, the doctor can check on the patient during the most critical phase of the healing process.
The initial healing usually happens throughout the first 6 weeks after surgery. However, the complete recovery can take up to 12 weeks or more.
After surgery, patients can experience swelling and post-operative pain. Swelling can take several weeks or months to disappear completely. Fortunately, cold compresses and ice packs can help the swelling fade faster.
Doctors also prescribe analgesics and anti-inflammatory medication to make the initial days after surgery more comfortable.
Since resting is essential for healing, taking a few weeks off before resuming work, school, and physical activities is highly recommended.
As expected, it is normal to have issues talking naturally, as you need to accustom to the new position of the bones and teeth.
Lastly, you must have a liquid diet after surgery and then move on to a soft diet. This prevents pain or issues while eating during the initial healing process.
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Corrective Jaw Surgery: Risks
Corrective jaw surgery is performed with extensive care after thorough planning to prevent issues. However, there is still a risk of complications and side effects.
Some of these risks include:
Anesthesia reaction
The patient can suffer an adverse reaction to anesthesia. This is often caused by allergies to the anesthetic.
Bleeding
Excessive bleeding and blood loss can happen if a large blood vessel is accidentally injured.
Numbness
The surgeon can accidentally damage a nerve, leading to temporary or permanent numbness of the lip or other mouth areas.
Jaw fracture
The bone might fracture in an undesired way while it is being separated.
Relapse
In some exceptionally uncommon cases, the maxillary or mandibular bone might move or return to its previous position.
Pain and swelling
These symptoms are the most common side effects of corrective jaw surgery. It can take a few weeks before these symptoms disappear.
Eating problems
It might take some time before the person can eat as usual again.
Infections
The surgery area might get infected. This can be identified by a foul odor and pus discharges.
Who is a good candidate for corrective jaw surgery?
This type of surgery is available for anyone suffering from facial asymmetry due to issues with taw bone development. Nonetheless, the person must comply with a few requirements, such as:
- The patient must be healthy. In case of suffering a systemic disease, it should be issued before the surgical procedure with adequate treatment.
- The bone must have finished its development. For this reason, this procedure can’t be performed on children or teenagers. In most cases, the person should be over 20 years old.
- The person should have a jaw bone defect or malocclusion that can’t be solved through regular orthodontic treatment.
Special considerations
Since corrective jaw surgery moves the entire bone, orthodontic treatment is usually necessary to align the upper and lower teeth and help them engage properly.
In most cases, you must undergo extensive orthodontic treatment before surgery. This aligns each dental arch individually. After surgery, you might need to continue with orthodontic treatment to align both dental arches entirely in the correct position.
Nonetheless, the dentist requires you to wait a few weeks until your bone heals before resuming orthodontic treatment.
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- 14 Reasons You Have Metallic Taste in Your Mouth
Additional Info
- Johns Hopkins Medicine
- Harvard University
- Encyclopedia Britannica
- Dental Press Journal of Orthodontics