Dental Services : Oral Surgery : Jaw Surgery

Orthognathic Surgery

Orthognathic surgery or jaw surgery is the procedure whereby either surgery is done on one or both jaws to reposition the jaws. Orthognathic surgery is aimed at correcting jaw alignment and occlusion in achieving facial harmony. When the jaws are moved forwards or backwards, up or down, or rotated, the facial soft tissue in the chin, cheeks, lips and tip of the nose move accordingly.

Orthognathic surgery is surgery performed on the bones of the jaws to change their positions. Orthognathic surgery is corrective facial surgery where deformities of the jaw exist. It may be indicated for functional, cosmetic, or health reasons. It is surgery commonly done on the jaws in conjunction with orthodontic treatment, which straightens the teeth.

Pre-operative planning is crucial to the success of the procedure and evaluates the surgical and orthodontic options. The surgeon chooses the type of mandibular surgery based on his experience, evaluation of the photographic and cephalometric analysis, and model surgery.

Orthognathic surgery is often delayed until after all of the permanent teeth have erupted unless medical conditions necessitate that the surgery be performed earlier. In adult patients, orthognathic surgery can be combined with soft tissue contouring to improve the aesthetic results.

ortho surgery

Jaw Surgery 

When thinking about undergoing orthognathic surgery, pre and post orthodontic treatment is normally required to ensure proper bite and successful results. Get a consult with your orthodontist today how resolve any bite occlusion concerns.

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Effects of Malocclusion

Malocclusion impedes jaw function and does not allow proper chewing of food and exert negative influence on food digestion and overall body health. Crowding of teeth aggravates oral hygiene maintenance and increases likelyhood of dental caries and periodontal disease

Malocclusion teeth may wear out faster and dental prostheses wear may be shorten.

Severe skeletal malocclusions caused by jaw mismatch in size and position may cause serious problems including

  • snoring and sleep apnea
  • undesirable mouth breathing
  • negative effect on speech function
  • jaw joint pain
  • affects overall facial profile aesthetics

Below are some of the conditions that may indicate the need for corrective jaw surgery. Always consult your dentists before determining if jaw surgery is suited or required for your case:

  • difficulty chewing, or biting food
  • difficulty swallowing
  • chronic jaw or jaw joint (TMJ) pain and headache
  • excessive wear of the teeth
  • significant open bite
  • unbalanced facial appearance from the front, or side
  • facial injury or birth defects
  • receding chin
  • protruding jaw
  • inability to make the lips meet without straining
  • chronic mouth breathing and dry mouth
  • sleep apnea (breathing problems when sleeping, including snoring)

Orthodontic treatment normally correct bites and problems with misaligned teeth, corrective jaw surgery may be to used to correct misalignment of the jaws.

Open Bite

jaw surgery open bite

Teeth are not aligned when uppper and lower jaws are closed.

Protruding Jaw

jaw surgery receding jaw

Upper jaw protrudes outwards from lower jaw

Receding Jaw

jaw surgery receding jaw

Lower jaw protrudes outwards to upper jaw

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Benefits of Jaw Surgery

  • Corrects and balances facial and dentation
  • Improves function, health, and appearance
  • Enables better biting and chewing on food
  • Close your lips together in certain caes
  • May improve speech
  • Prevents jaw joint disorder (TMJ) issues
  • improves quality of life

Procedure for Orthognathic Surgery

Orthognathic treatment takes is a complex and time consuming process that can take up to two years or more to complete. It consists of several stages and involves surgery as well as orthodontic treatment. The patient must clearly decide and understand once orthognathic treatment is started, the treatment is extremely difficult to reverse or switch to a non-surgical treatment.

  1. Preoperative diagnosis and planning
    • All dental specialists involved including orthodontist, oral and maxillofacial surgeon plans and diagnosis
    • All findings are analyzed and pre-surgical model surgery performed to ascertain the feasibility of various treatment options
  2. Pre-surgical orthodontics
    • Pre-surgical orthodontics may be necessary to straighten the teeth and align the arches so that a stable occlusion can be obtained post-operatively; orthodontic treatment may lasting between 18 to 24 months
  3. The maxillary surgery is done
    • Pre-operation preparation such as health check and labworks are done
    • orthognatic surgery is done under general anaethesia
  4. Post-surgical orthodontics
    • Orthodontics following surgery are frequently required to revise minor occlusal discrepancies that be last for about 6 months or more
    • Once the braces are removed, selected teeth may require other restorations such as dental implants or cowns leading up to the desired occlussion and facial profile

 

Recovery Expectations

The length of recovery in the hospital may vary from one to three days following surgery. During the week following surgery, activities should be limited. All strenuous activities and heavy exercise should be avoided the first month after surgery. Swelling is common, and a brief period of facial discoloration is possible.

Postcare Instructions after Orthognathic Surgery

  • As general anesthesia is used during your actual orthognathic surgery, you will be recommended to stay overnight at the hospital for monitoring and to ensure that bleeding has stopped
  • A companion should accompany you for the first 24 hours after you are discharged from hospital
  • Periodic bleeding is expected for the first week. This should not be excessive and will stop within minutes. With upper jaw, it is possible nose bleed may occur. Do blow your nose for around 2 weeks.
  • Do not rinse or spit for 24 hours after surgery.
  • Keep tongue away from the surgical area to avoid disturbing the surgical sites and allow blood to clot.
  • Bruising is normal after jaw surgery for the first 2-3 weeks. It could possibly extend down into the upper chest area.
  • Complete your course of antibiotics as directed. 
  • If you feel pain, take administered pain relieve medications.
  • Swelling is a normal. Apply cold compress over the area. Keep your head elevated for 2 weeks after surgery to help your sinuses drain.
  • You may experience some temporary numbness in the upper and/or lower lips. 
  • Avoid smoking and spitting.
  • Avoid hard and abrasive foods drinking plenty of liquids. Liquids diets are recommended during the first week. Moving on to soft foods cut in small pieces. Add on normal foods as your jaw heals and improves with function.
  • Cleaning and soft brushing will be required after each meal to keep the surgical sites clean and prevent infection. 
  • Rinse mouth gently with a solution of one-half teaspoon salt dissolved in a glass of warm water 3 times a day or with given mouth rinse.
  • Do not do strenuous activity or heavy lifting for 3 weeks after surgery.
  • Avoid excercise of sports involving a ball for 12 weeks. 
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