Jaw surgery, or fully called “Orthognathic Surgery combined with Orthodontics”, is a procedure to correct abnormalities of the jaw bones and to reposition the jaw bones and teeth into a new balanced position for proper occlusion and to enhance facial aesthetics. It is used to treat malocclusion problems that cannot be corrected by orthodontics alone. Generally, patients receive orthodontic appliances to correct the bite before surgery, and after surgery for a certain period. Orthodontists must work closely with oral and maxillofacial surgeons to collaboratively plan the treatment.
Jaw Surgery… What Problems Can It Fix?
- Chewing efficiency
- Correct speech or swallowing difficulties
- Reduce excessive tooth wear or tooth fractures
- Correct open bite or positions where teeth do not touch when biting fully
- Correct facial asymmetry or disproportion, such as short chin, excessive gum display when smiling, protruding chin, or abnormal lip posture
- Correct inability to close the mouth fully in a relaxed state
- Relieve sleep apnea or snoring conditions
Is Jaw Surgery Dangerous?
Jaw surgery is generally a safe procedure when performed by an oral and maxillofacial surgeon working in collaboration with an orthodontist. Jaw surgery should be done when the patient has stopped growing, typically around 18 years old for females and 20 years old for males.
Possible Risks After Surgery
- Blood loss
- Infection of the wound
- Numbness around the lips
- Unintended jaw bone fractures
- Relapse to the pre-surgery position
- Malocclusion or jaw joint pain
- Need for repeat surgery
- Need for root canal treatment or tooth loss
- Partial loss of jaw bone
Common Side Effects During Recovery
- Pain and swelling
- Difficulty eating, may require nutritional supplements
- Time needed to psychologically adjust to the changed facial appearance
Generally, orthodontists place braces about 12 to 18 months before surgery to align and level the teeth prior to surgery. Orthodontists plan treatment together with oral and maxillofacial surgeons, using X-rays, photographs, and bite models for treatment planning. In some cases, tooth reshaping may be necessary to correct the bite.
Three-dimensional computed tomography (3D CT) combined with treatment planning using 3D simulation software greatly assists in treatment planning and serves as a communication tool between the treating dentist and the patient.
Details Related to Jaw Surgery
Before Surgery
Jaw surgery is performed by an oral and maxillofacial surgeon under general anesthesia in a fully equipped hospital, with a hospital stay of 2-4 days for recovery.
During Surgery
The surgery is performed through the mouth, so there are no external scars on the face, chin, or around the lips. However, in some cases, a small external incision may be necessary.
The surgeon cuts and repositions the jaw bone to the planned position. Once the desired position is achieved, the bone is fixed with small metal plates and screws. These metal plates are small and can integrate with the bone over time.
In some cases, for aesthetic reasons, the surgeon may perform surgery on the jaw angle or chin simultaneously, after informing and consulting with the patient to achieve a facial appearance suitable for each individual. Lower jaw surgery (mandibular osteotomy)
- Corrects protrusion of the lower jaw
- Corrects retrusion of the lower jaw
- Corrects asymmetry of the lower jaw
The surgeon cuts the bone behind the molars on both sides, allowing the teeth and lower jaw bone in front to be moved. The jaw bone can be moved forward or backward. Once the desired position is achieved, the bone is fixed with metal plates.
Chin Surgery (Genioplasty)
Chin surgery can correct abnormalities such as a small or protruding chin, often associated with abnormalities of the lower jaw protrusion or retrusion. It can be performed together with lower jaw surgery by cutting the chin bone, repositioning it to the planned position, and fixing it with metal plates.
Postoperative Care
- Eat soft foods
- Maintain oral hygiene and wound care with a small toothbrush
- Avoid smoking
- Avoid heavy exercise
- Take pain medication
- Patients can return to work within one to two weeks
Wound healing and jaw bone recovery take about 6 weeks after surgery and may take up to 3 months for complete healing.
About 4-6 weeks after jaw surgery, patients will resume orthodontic treatment with the orthodontist. The combined orthodontic and surgical treatment process usually takes more than one to two years. Afterward, continuous follow-up with both the surgeon and orthodontist is necessary for long-term treatment monitoring.
Treatment Outcomes
Correcting tooth alignment and repositioning the jaw bones result in several benefits:
- Creates balance in the lower facial appearance
- Improves function and aesthetics of the teeth
- Benefits in sleeping, breathing, chewing, and swallowing
- Corrects unclear speech
- Enhances confidence and personality
Dr. Vetas Sakdechyon
Specialist in Oral and Maxillofacial Surgery
Dental Center, Phyathai 2 Hospital
