What to Expect During and After Orthognathic Surgery (Jaw Surgery)

If you're reading this, it's likely you or a loved one is facing the prospect of orthognathic surgery, also known as jaw surgery. We understand that it can seem a little daunting, with a whirlwind of questions whizzing around in your head. What's the process? Will it hurt? What about the recovery?

We're here to reassure you that you're in good hands. Just like any journey, knowing what to expect can help alleviate the anxieties and uncertainties surrounding the process.

Orthognathic surgery is a significant procedure, often recommended to correct a range of jaw-related issues that can't be rectified with braces alone. It's a transformative journey, with the potential to dramatically improve your quality of life by addressing chewing and speaking difficulties, enhancing facial aesthetics, and even reducing chronic discomfort.

In this blog post, we'll walk you through the journey, from the moment you step into the hospital for surgery, to the road of recovery post-operation. We'll aim to answer your pressing questions, giving you a clear picture of the process and leaving you better prepared for this life-changing procedure.

So, take a deep breath, muster up your courage, and let's dive into the world of orthognathic surgery! Remember, every step you take is one closer to a healthier, happier you.

Orthognathic Surgery

Orthognathic surgery also known as jaw surgery, is a complex surgical procedure, used to treat severe malocclusions, facial asymmetries, and jaw discrepancies. The aim of jaw surgery is to improve the alignment of teeth and skeletal facial abnormality. 

Oral and maxillofacial surgeons, orthodontists, and other dental specialists work together in a multidisciplinary manner to perform the difficult surgical operation known as orthognathic surgery. 

Jaw surgery is best used to enhance the functionality and aesthetic of the teeth where lightweight orthodontic treatments alone (like braces) might not work. 

Some common indications of the need for jaw surgery are:

•       Teeth malocclusion such as underbite or overbite due to protrusion and retrusion of upper and lower jaws.
•       To correct open bite, a condition in malocclusion in which the front teeth of the upper and lower jaws do not overlap with each other during bite.
•       To treat crossbite, a malocclusion problem in which upper and lower jaw molars do not coincide with each other during bite due to abnormal jaw growth.
•       To correct facial defects such as prognathism (forward) and retrognathism (backward) jaw growth.
•       Correct facial aesthetics such as facial asymmetry due to abnormal jaw growth.
•       To correct genetic craniofacial defects, such as cleft lip and palate (underdeveloped plate or upper jaw), and Pierre robin sequence (genetic defect in development of lower jaw).
•       To Repair jaw injury and temporomandibular joint (TMJ) disorder.
•       Resolve breathing problems such as sleeping apnea due to abnormal jaw position.

Jaw Surgery Before And After

Before Jaw Surgery

Before the jaw surgery, the orthodontist performs a comprehensive examination of the teeth, jaws, and TMJ joints. 

Usually, the medical professional takes photographs of the teeth and face, examines your bite impression on a cast, and performs full mouth X-rays such as OPG and lateral cephalogram X-ray to examine facial skeletal structures. This procedure 

These diagnostics help in the assessment of the cause of abnormal jaw relation and teeth malocclusion and also help to confirm the root cause of skeletal problems.

After a detailed assessment, your orthodontist makes a treatment plan for your jaw surgery that helps in a successful surgical outcome.

Jaw surgery is generally performed by the oral maxillofacial and orthodontic surgeon in a hospital under general anesthesia. 

Generally, Incisions are made inside the mouth to avoid scars but sometimes small incisions also make on the face. 

After the incision, bones of the upper and lower jaws are repositioned or aligned according to the treatment plan or requirements. Sometimes grafts are placed from another part of the body to fill the defect. Then sutured the incision and keep on follow-up for a healing assessment.

After Jaw Surgery

After your jaw surgery, pain, discomfort, facial swelling, and difficulty in mouth opening are the common side effects. Facial swelling remains at least for a week then gradually subsides. Your doctor will prescribe painkillers and antibiotics to control swelling, pain, and infection.

Soft diets are recommended for a few weeks and regular dental follow-ups for healing assessments. 

It is also advised to practice jaw exercises that help in mouth opening after the surgery. 

Maintaining oral hygiene is very important after jaw surgery. The use of soft brushes and mouthwashes is recommended after every meal.

Jaw Surgery Recovery Time

Jaw surgery takes around three months to recover oral health completely, during which tissues and new bones form around the newly repositioned jaw bone. 

Orthodontic surgeons also place band screws or wire during jaw surgery to hold the jaw bone at the new position. 

After the surgery, you'll have follow-up appointments with your surgeon. During these visits, the surgeon might adjust the band screws or wires based on how well your jaw is healing. If your jaw has healed and is stable in its new position, the surgeon might decide to remove these supports.

You can observe improvement in facial aesthetic, and functional bite after one week of surgery when facial swelling resolves completely.

Types of Jaw Surgery

•       Jaw Realignment Surgery
•       Jaw Reconstruction Surgery
•       Crook Jaw Surgery

Jaw Realignment Surgery

This is a comprehensive surgery in which the upper and lower jaw align to achieve perfect occlusion and aesthetics. Jaw realignment surgery is performed on either the upper jaw or lower jaw according to the skeletal abnormality. 

In some complex cases, realignment surgery is performed in both jaws. In realignment jaw surgery, the surgeon makes an incision, cut the jaw, and realigns it in the correct position.

Upper jaw realignment surgery (maxilla osteotomy) is performed in those conditions in which the upper jaw is more forward or backward in growth as compared to the lower jaw. Upper jaw protrusion or retrusion can produce an open bite, flaring of front teeth, and cross bite that can affect aesthetics, chewing, and speech.

Lower jaw realignment surgery (mandibular osteotomy) is used to correct a receding lower jaw or a protruding lower jaw. Abnormality in the lower jaw can produce a deep bite, overbite, and increased or decreased facial height.

 Jaw Reconstruction Surgery

Reconstruction jaw surgery is commonly used to correct facial bone defects due to genetic defects such as cleft lip and plate. This procedure is performed on the upper and lower jaws to fill the defect by adding graft bone from the other part of the body. Hip and rib bones are commonly used for grafting.

Facial bone defects can affect aesthetics, breathing, swallowing, chewing, and speech, which is why Jaw reconstruction is commonly performed at a young age to overcome the complications.

Crook Jaw Surgery

Crook jaw surgery is used to correct complex jaw problems. There are multiple reasons why a patient would have a crooked jaw. It could be due to genetic defects, trauma, or temporomandibular joint defects. A crooked jaw can produce pain in the temple region, difficulty in jaw movement click sound, and abnormal bite.

Crook jaw surgery corrects the jaw's position, teeth alignment, and facial aesthetic. Realignment and reconstruction surgeries are often involved in crook jaw surgery in order to get the desired result.

Jaw Surgery Result

•       Jaw surgery can produce amazing changes on the face, especially in the case of birth jaw defects and facial asymmetry. The important effect of jaw surgery is on facial aesthetics, smile, midline symmetry, and improved facial height.
•       The maxillofacial surgeon with orthodontist can improve the symmetry of the entire face structure by adjusting the jawbones' misalignments and abnormalities. Patients frequently notice a more attractive facial profile with better chin, jawline, and cheek alignment.
•       Jaw surgery can significantly enhance oral health in addition to the aesthetic benefits.
•       Jaw surgery produces it effect on teeth alignment, speech, and swallowing. Gum health and oral hygiene also improve with jaw surgery by teeth alignment treatment.
•       Jaw surgery reduces the duration of orthodontic treatment and gives better and more successful outcomes on teeth alignment.
•       Jaw surgery improves temporomandibular joint disorder, and removes clicking sound and jaw stiffness during mouth opening. 

Jaw Surgery Road To Recovery

After your jaw surgery, the recovery phase is also important for successful results. During recovery, new tissues are formed around the jaw and you must take necessary precautions so they form properly. 

Excessive mouth opening can hinder normal healing procedures and one should take a soft diet for one week after the surgery.

You will feel some pain and face swelling during the first few weeks post-surgery. We recommend you use ice packs to soothe the pain and swelling.

After 14 days of surgery, mouth opening exercises are recommended to reduce scarring and jaw stiffness.

Follow-up sessions after jaw surgery are important to track recovery and resolve any issues. Orthodontists will examine the wound's progress, take out any sutures or wires, and offer advice on proper mouth hygiene techniques.

During surgery screws and bands are placed to remain the jaw at new positions, these bands and wires should be adjusted by orthodontic during regular dental visits.

Jaw exercises may be suggested to help with the healing process. The goals of these workouts are to increase overall function, strengthen facial muscles, and regain jaw movement. Post-operative instructions can aid in a speedy recovery and improve the operation's overall results.

Oral hygiene maintenance is a crucial task after your jaw surgery. Regular dental visit is important to monitor oral health.

Following jaw surgery, a recovery period of approximately 3 to 4 months is generally required for initial healing and bone fusion. Once recovered, the orthodontic treatment plan resumes, often involving the application of braces to fine-tune tooth alignment and correct any remaining skeletal issues. This final phase, which can span several months to over a year, is essential for achieving optimal functional and aesthetic results, completing the comprehensive orthodontic journey that the jaw surgery is a part of. 

Conclusion

Jaw surgery can help in improving skeletal defects, aesthetics, and speech function. Jaw surgery also corrects tooth malalignment, and resolves TMJ disorder. 

Note that to get the best results, proper exercise, medication, and follow-up are important for the stability of jaws after the surgery.

Following the orthodontist’s recommendations and post-operative care can produce successful recovery and long-lasting outcomes. 

You can start your orthodontic journey with Bruno Ortho. We specialize in a range of orthodontics treatments including orthognathic/jaw surgery. Our treatments cater to both adults and children — no one is left behind. Contact Brutho Orthodontics today to schedule your consultation and let us help you reveal your best smile yet!