Jaw Surgery Procedure
Overview
Orthognathic surgery, often called jaw surgery, is a medical procedure used to correct misaligned jawbones or irregular jaw growth. The main goal is to improve jaw function and facial appearance. This type of surgery is often recommended when braces alone cannot correct the issue.
A combined approach is common. Patients typically wear braces both before and after surgery to guide proper alignment. Surgeons may reposition the upper jaw, lower jaw, or both, depending on the individual’s needs.
Treatment is usually planned by a team that includes an orthodontist and a maxillofacial surgeon. Most candidates have completed growth—typically between ages 16 to 18 for females and 18 to 21 for males. Timing depends on individual development.
| Term | Description |
|---|---|
| Orthognathic surgery | Surgery for correcting jaw alignment |
| Maxillofacial surgery | Surgical treatment for jaw and facial area |
Reasons for Jaw Surgery
Surgeons perform corrective jaw surgery for several important reasons. It can help correct an improper bite, making it easier to chew and swallow food. Some people have an open bite or a protruding jaw, which causes problems with mouth closure, speaking, and eating. Common jaw conditions surgeons treat include:
- Open Bite: When front teeth do not touch even when back teeth are together.
- Protruding Jaw: When the lower jaw juts out beyond the upper jaw.
- Breathing Problems: Including obstructive sleep apnea, which can improve after jaw alignment.
- Jaw Pain: Such as discomfort from temporomandibular joint disorder (TMJ).
Possible Complications
Jaw surgery carries several potential risks, even when skilled surgeons perform it and coordinate with orthodontic care. Common risks include:
- Bleeding
- Infection
- Nerve damage (which can cause numbness or tingling)
- Jaw fractures
- Jaw moving back to its previous position
- Problems with bite alignment or jaw joint pain
- Possible need for additional surgery
- Chance of losing part of the jaw bone
- Root canal treatments on certain teeth
Patients may also experience temporary effects such as pain, swelling, eating issues, and speech difficulties, which usually improve as healing progresses. Dietitians may recommend eating supplements.
Preparing for Jaw Correction
Orthodontic treatment usually starts the preparation for jaw correction. Most patients get braces from an orthodontist before surgery. The braces stay in place for about 12 to 18 months to straighten and position the teeth for surgical changes.
In some situations, patients need to wear braces longer if earlier treatments moved teeth in a way that needs to be reversed. A few people might have surgery before beginning orthodontics. In these rare cases, the orthodontist usually places the braces right before the surgery.
The orthodontist and the oral and maxillofacial surgeon work together, using x-rays, digital photos, and dental molds to plan the treatment. This planning sets the correct jaw and tooth position. Sometimes teeth need reshaping or crowns to achieve a proper bite.
Virtual Planning Tools
Virtual surgical designs and 3D simulations help plan the procedure and show if extra orthodontic work is needed after surgery. 3D printing technology creates cutting guides and plates that help surgeons move jawbones with high accuracy during surgery.
Key Steps in Preparation
| Step | Purpose |
|---|---|
| Braces | Align and level teeth |
| X-rays and images | Help with planning |
| 3D scans & virtual guides | Improved accuracy |
| Crowns/reshaping teeth | Fix bite or fit issues |
What You Can Expect
Preparing for Surgery
A trained oral and maxillofacial surgeon usually carries out jaw surgery at a hospital. Patients typically receive general anesthesia to make them sleep during the operation. The length of stay in the hospital can vary. For some, it is just the day of surgery. Others may remain in the hospital for a few days, especially if the surgery is complex or involves more than one part of the jaw.
Before the procedure, patients are often asked not to eat or drink for several hours. The care team gives instructions on medications, hygiene, and any final steps before surgery. These may include brushing teeth with a special rinse or stopping certain medicines.
Pre-surgery instructions help reduce risks and ensure a smooth recovery. Patients should follow all guidance closely and ask questions if anything is unclear. The surgical team will also review the plan one last time and confirm details, such as anesthesia, timing, and what to expect afterward.
What Happens During Surgery
Surgeons perform most jaw surgeries with incisions inside the mouth, so scars are not usually visible on the face. In rare cases, they make tiny cuts on the skin, but these are placed in less noticeable spots and are usually very small.
Surgical Process
- The surgeon makes precise cuts in the jawbone(s).
- The surgeon moves the jaw into its new, improved position.
- The surgeon uses tiny plates, screws, or wires to keep the bones in place.
- Rubber bands may connect the jaw to braces to guide healing.
- If needed, the surgeon adds, reshapes, or removes bone. Sources for extra bone include the hip, rib, leg, or synthetic bone grafts.
Procedures for the Top Jaw
Upper jaw surgery, also called maxillary osteotomy, can fix several problems such as a jaw that sticks out, too much or too little of the teeth showing, crossbites, and open bites. Problems in this area often impact facial appearance and chewing.
Surgical Steps
| Problem Fixed | Surgical Correction |
|---|---|
| Jaw sticks out or sinks in | Move forward or backward |
| Too much or little teeth showing | Raise or lower upper jaw |
| Open bite | Remove extra bone above molars |
| Crossbite | Widen or shift jaw for proper alignment |
| Midfacial hypoplasia | Adjust jaw position for facial balance |
- The surgeon cuts above the upper teeth to move the entire upper jaw, including the roof of the mouth, as a single piece.
- The surgeon can move the jaw forward, backward, higher, or lower to match up with the lower jaw.
- Sometimes, the surgeon widens a small upper jaw by making extra cuts through the roof of the mouth.
- If too much bone above the molars creates a slanted bite, the surgeon shaves or removes that bone.
Once the surgeon sets the new position, plates and screws hold the upper jaw steady so it can heal.
Procedures for the Lower Jaw
Surgeons perform lower jaw surgery, called mandibular osteotomy, to fix a jaw that sits too far back or sticks out too much.
Surgical Steps
- The surgeon makes cuts behind the lower molars and down the jawbone.
- The surgeon moves the front part of the jaw (with the teeth) as needed, forward or backward.
- Plates and screws hold the bone in its new position.
Modifying the Chin
If someone has a small chin (sometimes linked with a lower jaw that sits back), surgery may help. This is often done at the same time as lower jaw surgery.
Surgical Steps
- The surgeon makes a cut in the bone of the chin.
- The surgeon moves the bony piece forward to create a more balanced profile.
- Plates and screws secure the piece.
Patients can expect improved chin size and position, which helps the overall appearance of the lower face.
Recovery and What Comes Next
After surgery, healthcare staff give patients clear instructions for caring for their mouth and overall health. Instructions often include:
- Eating soft or liquid foods at first, then a slow return to normal foods.
- Good mouth hygiene to help healing.
- Not using tobacco products.
- Avoiding physical activities that need a lot of energy.
- Directions for taking pain medicine safely.
- Arrangements for return to work or school (usually after 1-3 weeks).
Healing Timeline
- Initial healing takes about six weeks.
- Full healing may take up to 12 weeks.
- During healing, some swelling, numbness, or mild pain can occur.
- The care team creates a follow-up visit schedule for checking progress and removing any non-permanent hardware.
After around six weeks, an orthodontist may adjust braces to complete aligning the teeth. The full process – including surgery and dental work – can last several years. Patients may receive a retainer once braces come off to help maintain the new bite.
| Stage | Expected Timeframe |
|---|---|
| Hospital stay | Hours to a few days |
| Initial jaw healing | 6 weeks |
| Full jaw recovery | Up to 12 weeks |
| Returning to work/school | 1 to 3 weeks |
| Full orthodontic process | Several years |
Outcomes
People often notice that their teeth fit together better, which helps with basic functions like chewing and swallowing. Some also breathe and sleep better. If jaw alignment caused problems before, speech may become clearer. Many individuals report a boost in self-confidence due to these changes.
