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1. What is it? Any common name for this procedure?
Orthognathic surgery, widely known as corrective jaw surgery, is a major surgical procedure designed to reposition the upper jaw (maxilla), lower jaw (mandible), or chin (genioplasty) to correct skeletal and dental irregularities. Unlike minor dental adjustments, this surgery addresses the underlying bone structure when orthodontic braces alone cannot fix a "mismatched" bite.
The procedure is a collaborative effort between an oral and maxillofacial surgeon and an orthodontist. It often involves moving the bones in various directions—forward, backward, up, down, or rotating them—and securing them with permanent biocompatible plates and screws.
Common Names & Techniques:
· Corrective Jaw Surgery
· Le Fort I Osteotomy: Moving the upper jaw.
· Bilateral Sagittal Split Osteotomy (BSSO): Moving the lower jaw.
· Genioplasty: Repositioning the chin to improve facial harmony.
· Maxillomandibular Advancement (MMA): Moving both jaws forward, typically to treat sleep apnea.
2. Common Symptoms / Indications for This Procedure
Patients typically consider orthognathic surgery when functional issues cannot be resolved through non-invasive means:
· Malocclusion (Improper Bite): Significant underbites, overbites, or crossbites.
· Difficulty Chewing or Swallowing: Inability to properly masticate food due to jaw misalignment.
· Anterior Open Bite: A gap between the upper and lower front teeth when the mouth is closed.
· Facial Asymmetry: Noticeable imbalance in facial features, such as a "shifted" chin or lopsided jawline.
· Obstructive Sleep Apnea (OSA): Chronic snoring and breathing pauses during sleep caused by a narrow or recessed airway.
· Chronic TMJ Pain: Persistent jaw joint pain or headaches that have not responded to conservative treatments.
· "Gummy" Smile: Excessive show of the upper gums when smiling.
3. List of Associated Diseases and Conditions
While sometimes necessary due to trauma, orthognathic surgery is frequently used to treat congenital or developmental conditions:
· Craniofacial Syndromes: Including Apert, Crouzon, Treacher Collins, and Pfeiffer syndromes.
· Cleft Lip and Palate: To correct the skeletal imbalances often remaining after early childhood repairs.
· Hemifacial Microsomia: A condition where one side of the face is underdeveloped.
· Pierre Robin Sequence: A condition characterized by a very small lower jaw and breathing difficulties.
· Acquired Deformities: Such as those caused by severe facial fractures or the surgical removal of jaw tumors.
4. List of Screening Tests and Assessment Tools
The planning for this surgery is highly technical and often starts over a year before the operation:
· CT Scan Provides a high-resolution 3D map of the facial bones and nerves.
· Cephalometric X-rays: Standardized X-rays used to measure the relationship between the teeth, jaw, and skull.
· Digital Dental Scans: Intraoral scans to create a precise virtual model of the teeth.
· Virtual Surgical Planning (VSP): Software that allows surgeons to simulate the movements before the actual surgery to ensure precision.
· Sleep Study (Polysomnography): Required if the surgery is being performed to treat Obstructive Sleep Apnea.
5. Am I Eligible for This Procedure?
Eligibility is strictly governed by both skeletal maturity and functional necessity:
· Completion of Growth: Jaw surgery is usually delayed until facial growth is complete. This is typically ages 16 to 18 for females and 18 to 21 for males.
· Orthodontic Preparation: Most patients must have braces for 12 to 18 months before surgery to align the teeth within each individual jaw.
· Good Systemic Health: Patients must be fit for general anesthesia and free of active gum disease or uncontrolled metabolic disorders.
6. Pre and Post Care for This Procedure
Pre-Care (The "Decompensation" Phase):
· Pre-surgical Orthodontics: Braces are used to move teeth into their ideal position relative to the jawbone, which may temporarily make the bite look worse until surgery fixes the bone.
· Fasting: No food or drink for at least 8 hours prior to the procedure.
Post-Care (The Recovery Phase):
· Immediate Post-Op: Facial elastics (rubber bands) are often used to guide the jaw into its new position; the jaws are rarely "wired shut" in modern 2026 practice.
· Dietary Restrictions: A strictly liquid or pureed diet for the first 1–2 weeks, transitioning to soft foods (pasta, fish) for up to 6 weeks.
· Oral Hygiene: Specialized gentle brushing and salt-water rinses to keep internal incisions clean.
· Activity Limits: No strenuous exercise or contact sports for 8 weeks to allow the bones to fuse.
· Post surgical orthodontics
7. Days Required for Hospitalization
Orthognathic surgery is an inpatient procedure performed under general anesthesia.
· Standard Hospital Stay: 1 to 3 days.
· Initial Recovery: Most patients can return to work or school after 2 to 4 weeks, though full bone healing takes about 3 to 4 months.
· Hospitalization: 1–3 Days.
Disclaimer: As per doctor’s advice, the hospitalization period may be modified if multiple jaw segments are moved or if the patient requires additional monitoring for airway safety.
8. Benefits of This Procedure
· Enhanced Function: Dramatic improvement in the ability to chew, bite, and swallow effectively.
· Resolution of Sleep Apnea: Advancing the jaws can significantly open the airway, often eliminating the need for a CPAP machine.
· Facial Harmony: Correction of skeletal discrepancies results in a more balanced facial profile and can improve the aesthetics of the nose and chin.
· Dental Longevity: A proper bite prevents excessive wear and chipping of the teeth over time.
· Speech Improvement: Can resolve certain speech impediments caused by severe overbites or open bites.
