Orthognathic surgery refers to a range of surgical procedures that are performed on the upper and lower jaw and chin to improve function and/or appearance. Continue reading to learn more about this treatment and what to expect if you have been recommended jaw surgery.
What is orthognathic surgery?
Orthognathic surgery is also called corrective jaw surgery or jaw straightening surgery. It is an umbrella term for a range of procedures undertaken to readjust or realign the jaw. Jaw surgery is done to improve misalignment, improve the fitting of the teeth together, normalize or balance facial proportions, and treat conditions such as TMJ and obstructive sleep apnea.
You may be a candidate for orthognathic surgery if you have a bite discrepancy (overbite, underbite, openbite, or crossbite). Patients with under-development of the upper or lower jaw, under-development of the chin, or any type of jaw malformation or misalignment can benefit from these procedures. Medical conditions like sleep apnea and TMJ jaw pain may also benefit from orthognathic surgery. Cosmetic reasons for performing corrective jaw surgery include correcting facial asymmetries to improve aesthetics.
When is corrective jaw surgery medically necessary?
Some of the medical reasons for performing orthognathic surgery include:
- Adjusting the bite so that the teeth fit together well to make biting and chewing easier.
- Correcting asymmetry in the face.
- Easing pain from temporomandibular joint syndrome (TMJ).
- Repairing birth deformities such as cleft palate.
- Addressing breathing problems like sleep apnea or mouth breathing.
Types of orthognathic surgery
Maxilla osteotomy
This is a surgery of the maxilla or upper jaw. Called a Lefort I maxillary osteotomy, it is done to correct a significantly protruding or receding upper jaw. It may also be performed to correct an open bite or cross bite. The surgeons access the upper jaw through incisions in the gums. They then move the upper jaw to correct the bite problems and align the upper and lower jaws better. Plates and titanium screws are used to adjust the bones in the new positions.
Mandible osteotomy
This is a surgery performed on the mandible or lower jaw. Incisions are made in the gums near the lower molars. The surgeons then cut the lower jaw bone and move it into a new position, either forward or backward, using plates and screws to hold it there. A type of orthognathic surgery called bilateral sagittal split osteotomy involves separating the lower jaw from the face and repositioning it forward (if it is too far back) or straight (if it is tilted).
Bimaxillary osteotomy
This is a complex combination procedure that involves both maxillary and mandibular osteotomies. Sometimes, a process called distraction osteogenesis is used to make a bone longer. Surgeons often use 3D modeling software to plan this type of complex surgery.
Genioplasty
This is a chin surgery that is done to treat a receding chin. The incision is usually made near the lower lip. The surgeons then cut the chin bone and move it into new position, using plates and screws to hold it in place.
Temporomandibular joint surgery
Surgery is recommended for temporomandibular joint disorder when other treatments have not worked. This type of corrective surgery on the jawbone can involve either minimally invasive arthroscopic surgery or open jaw surgery.
What to expect with corrective jaw surgery
Consultation
The first step in undergoing orthognathic surgery is a consultation with an oral and maxillofacial surgeon and orthodontist. The appointment is used to obtain detailed health information, including obtaining imaging studies like X-rays and CT scans, impressions of the teeth, making dental models, etc. In some patients, the orthodontist may place aligners or braces on the teeth for a few months before the surgery to prepare for the procedure.
Surgery
Corrective jaw surgery is done under general anesthesia. The surgeon will make incisions in the mouth and cheeks. They will then mobilize the jaw bones and fix them in new positions with screws and plates. A splint or fixed mouth guard may be left in place after the surgery. The entire procedure can take 2 to 5 hours to complete depending on the complexity of the surgery.
Recovery and aftercare
Most people require a 1- to 4-day hospital stay after orthognathic surgery. You will receive specific instructions about eating a pureed diet and rinsing your mouth with antibacterial mouth wash after the procedure. You will also receive pain medication to help with the initial discomfort after orthognathic surgery. Most patients can go out in public after 10-14 days, but complete healing can take many months.
Results
The results of orthognathic surgery are long-lasting or permanent and visible immediately. However, it is worth noting that changes can occur in the jaw as you continue to age naturally. You will notice improvement in function and/or appearance in the months following the procedure as the swelling and bruising resolve. Although the swelling usually resolves rapidly in the days following surgery, some subtle swelling can persist for several months after jaw surgery. The incisions for corrective jaw surgery are mostly inside the mouth, so there is no visible scarring. Some very small incisions may be made outside the mouth, but they are unlikely to leave any prominent scars.
Is orthognathic surgery painful?
The surgery itself is performed under general anesthesia, so you will not feel any pain during the procedure. After the surgery, once the anesthesia has worn off, there will be some discomfort or pain for a few days as the surgical sites heal. This can be managed with pain medications.
Risks of jaw surgery
Besides common surgical risks such as anesthesia risks, bleeding, and infection, the potential complications of orthognathic surgery include damage to the teeth, problems with the jaw joint, swelling, bruising, numbness, recurrence of the original problem, and improper healing of the jaw bones. When performed by an experienced surgeon, these risks are low.
How much does orthognathic surgery cost?
The cost of orthognathic surgery varies greatly, depending on the extent of the procedure. It can range anywhere from $20,000 to $40,000. Jaw surgery may be covered by insurance if it is deemed medically necessary and is performed to correct a functional problem.
Finding a surgeon for orthognathic surgery
If you suffer from bite problems, abnormal jaw growth, face asymmetry, difficulty chewing, sleep apnea, TMJ, or other problems in the jaw area or teeth, you could potentially benefit from orthognathic jaw surgery. The MeTime app makes it easy to find an experienced maxillofacial surgeon and orthodontist in your area. You can click and upload pictures, chat with oral and maxillofacial experts, schedule a video consult, and have suggestions sent directly to you. Find out more about jaw surgeries and how they could help you. Download the MeTime app now!
