Orthognathic surgery is jaw surgery. It is performed to correct the conditions of the lower jaw and the face.
The surgery aims to realign the jaws and teeth to improve their function and aesthetic appearance. Jaw surgery is usually performed after the growth stops, which is around ages 14 to 16 years for females and 17 to 21 years for males. The surgery is performed under general anesthesia, so there is no pain during surgery. Patients usually experience pain after the anesthesia wears off, which can last for a few days. This can be managed with painkillers.
Why is orthognathic surgery done?
Jaw surgery may be performed to:
- Correct dental problems, which cannot be managed by braces
- Help make biting and chewing easier
- Reducing wear and tear and breakdown of the teeth
- Correct bite fit or jaw closure issues
- Correct facial asymmetries, such as small chins, underbites, overbites, and crossbites
- Help the lips to fully close comfortably
- Relieve pain caused by temporomandibular joint (TMJ) disorders and other jaw problems
- Repair facial injuries or birth defects
- Treatment of obstructive sleep apnea
How is orthognathic surgery performed?
Orthognathic surgery is performed by oral and maxillofacial surgeons. The surgery is performed under general anesthesia in the hospital. Surgery is usually performed from the inner side of the mouth, hence there would not be any external facial scars. Sometimes, small incisions may be required outside of the mouth, but they usually heal well. The surgeon makes cuts in the jawbones and moves the pieces into the correct position.
Small bone plates, screws, wires, and rubber bands may be used to secure the bones into the new position. These screws are smaller than the size of a bracket used for braces. They become integrated into the bone structure over time. In some cases, extra bone may be taken from the patient’s rib, hip, or leg to be added to the jaw. Sometimes the bone may be reshaped to provide a better fit and appearance. Jaw surgery may be performed on the upper jaw, lower jaw, chin, or any combination of these.
After the procedure:
The patient usually stays in the hospital or 2-4 days after surgery. The patients would have pain, swelling, and bruising, which usually resolves in 2-3 weeks. The patient would be administered painkillers, anti-inflammatories, and antibiotics.
After surgery, the doctor will provide instructions on what to eat, what to avoid, how to maintain oral hygiene, how the healing will happen, what activities are permissible, when to return to work, and when to follow-up. Initial jaw healing typically takes around 6 weeks after surgery. Complete recovery can take up to 12 weeks. After initial jaw healing (after around 6-8 weeks), the orthodontist may apply braces if the teeth require alignment. The entire orthodontic process, including surgery and braces, can take several years.
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What are the complications of orthognathic surgery?
Jaw surgery is usually a safe surgery. The risk of serious complications is usually rare if performed by an experienced oral and maxillofacial surgeon. Some possible risks of surgery may include:
- Bleeding
- Infection
- Nerve injury
- Jaw fracture
- Relapse of the jaw to the original position
- Jaw joint pain
- Need for root canal therapy on selected teeth
- Loss of part of the jaw
- The requirement of an additional surgery
- Reaction to anesthesia