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.
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:
- 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
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Khechoyan DY. Orthognathic Surgery: General Considerations. Semin Plast Surg. 2013;27(3):133-136. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805731/
Current Therapy in Oral and Maxillofacial Surgery. Orthognathic Surgery. Science Direct. 2012. https://www.sciencedirect.com/topics/medicine-and-dentistry/orthognathic-surgery
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Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
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propofolPropofol is an intravenous anesthetic drug used for general anesthesia and sedation during surgical procedures. Common side effects of propofol include injection site burning, stinging or pain; low blood pressure (hypotension), reduced cardiac output, elevated blood pressure (hypertension), pause in breathing (apnea), lung impairment (respiratory acidosis), impaired movement, high level of emulsified fats in the blood (hyperlipidemia), and high triglyceride level in blood (hypertriglyceridemia). Abuse of propofol can cause death and other injuries.
succinylcholineSuccinylcholine is a skeletal muscle relaxant used for medical procedures done under general anesthesia, including tracheal intubation, mechanical ventilation, and surgeries. Common side effects of succinylcholine include postoperative muscle pain, jaw rigidity, muscle twitch (fasciculation), respiratory depression, cessation of breathing (apnea), low or high blood pressure (hypotension or hypertension), irregular heart rhythms (cardiac arrhythmias), slow or rapid heartbeat (bradycardia or tachycardia), cardiac arrest, increase in intraocular pressure (IOP), high blood potassium levels (hyperkalemia), severe life-threatening drug reaction with excessively high temperature (malignant hyperthermia), salivary gland enlargement, excessive salivation, rash, hypersensitivity reactions, and others.
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