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by Jones P
(Orthognathic Surgery; Maxillofacial Surgery; Maxillary Osteotomy; Mandibular Osteotomy)

Definition

Corrective jaw surgery will reshape or reposition the jaw bones. The surgery may be done on the upper jaw, lower jaw, or both. This surgery may also be called:

  • Maxillary osteotomy—upper jaw
  • Mandibular osteotomy—lower jaw

The bone should heal in about 6 weeks. It will take about 9 to 12 months before the jaw fully heals.

The Upper and Lower Jaw Bones
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Reasons for Procedure

The surgery is done to correct problems of the jaw. It may change how the jaw works or repair damage. The jaw is the platform for the teeth. Certain jaw problems make it hard for the upper and lower teeth to line up as they should. This could lead to:

  • Difficultly chewing or biting
  • Speech problems
  • Breathing problems
  • Problems breathing during sleep, such as sleep apnea
  • Jaw pain

The jaw may also need repairs due to one of the following:

  • Facial injuries
  • Birth defects
  • Genetic conditions
  • Bone disease or conditions that affect bone growth

The surgery may also be done to change the appearance of the face. It may be used for receding chin, protruding jaw, or lips that don’t meet.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review problems that could happen such as:

  • Numbness or pain in sinuses, ears, or teeth
  • Excess bleeding
  • No improvement in symptoms
  • Poor cosmetic outcome
  • Adverse reaction to anesthesia, such as lightheadedness, low blood pressure, and wheezing
  • Infection
  • Nausea and vomiting

Factors that may increase the risk of problems include:

  • Smoking
  • Bleeding disorders
  • Chronic health conditions, such as heart disease

Talk to your doctor about these risks before the procedure.

What to Expect

Prior to Procedure

Your teeth may need to be adjusted before surgery. This will help to make sure they are in line with the new jaw. You may need several months of dental care. Braces or similar tools may be used to help shift your teeth into the right position.

An x-ray and models of your teeth may be done closer to surgery. This will help guide work in surgery.

Talk to your doctor if you take any medicine, herbs, or supplements. You may be asked to stop taking some medicine up to 1 week before the procedure.

You may be asked to not eat or drink anything starting the night before your surgery.

Anesthesia

General anesthesia will be used. It will block pain and keep you asleep through the surgery.

Description of the Procedure

The exact steps will depend on your specific needs. Most cuts will be made inside the mouth.

Repairs to the bone may include:

  • Removing a section of bone
  • Separating a section of the jaw so that is can be moved backward or forward
  • Reattaching the new edges of bone with metal plates, screws, or wires

The bones will be adjusted until the upper and lower teeth are lined up.

The incisions may be closed with stitches or a glue-like liquid. Gauze may be placed over the surgical wounds. The gauze will stay in place for a few hours after surgery. Rubber bands may be used to help keep your jaw in the right place. They are attached to appliances on the teeth.

Immediately After Procedure

After the operation, you will be taken to the recovery room. A care team will help you wake up and check your vital signs. The gauze may be removed when you wake up.

Ice may be placed around your jaw to decrease swelling.

How Long Will It Take?

The length of surgery will depend on the needs. It may be 2-4 hours.

How Much Will It Hurt?

Anesthesia prevents pain during surgery. As you recover, you will have some pain. Your care team will give you medicine to help manage any pain.

Average Hospital Stay

You may need to stay in the hospital for 2-5 days. If you have any problems, you may need to stay longer.

Post-procedure Care

You will likely need to start with a liquids or soft food diet. As the jaw heals you will slowly be returned to your normal diet. The schedule will depend on how much work was done. A dietitian will help with meal planning.

  • You will be able to notice cosmetic change right away.
  • Your jaw will need to heal before you can do normal movements. It may take some time to feel the improvements in bite or jaw movement.
At Home

Some activities will need to be avoided until the jaw is healed.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

  • Signs of infection, including fever and chills
  • Redness, swelling, excess bleeding, or discharge from the surgery site
  • Foul smelling breath
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications you were given
  • Spitting or vomiting blood
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

American Academy of Periodontology  http://www.perio.org 

American Association of Oral and Maxillofacial Surgeons  http://www.aaoms.org 

CANADIAN RESOURCES

Canadian Dental Association  http://www.cda-adc.ca 

Dental Hygiene Canada  http://www.dentalhygienecanada.ca 

References

Corrective jaw surgery. American Association of Oral and Maxillofacial Surgeons website. Available at: http://myoms.org/procedures/corrective-jaw-surgery. Accessed May 27, 2018.

Home care after surgery. Fallon Oral Surgery of Syracuse. Available at: http://www.fallonoralsurgery.com/forms/Home%5FCare%5FAfter%5FSurgery.pdf. Accessed May 27, 2018.

Orthognathic surgery. Harvard Oral and Maxillofacial Surgery. Available at: http://www.massgeneral.org/omfs/services/procedure.aspx?id=2166. Accessed May 27, 2018.

Oral wound care after Mohs Surgery. University of Wisconsin-Madison. Available at: http://www.uwhealth.org/healthfacts/wound-skin/4941.html. Accessed May 27, 2018.

Revision Information