Orthognathic Jaw Reconstruction

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 9-12 months before the jaw heals completely.

The Upper and Lower Jaw Bones

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Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• 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.

Reasons for Procedure

This surgery is done to correct a problem of the jaw bone.

The jaw is the platform for the teeth. Certain jaw problems make it difficult for the upper and lower teeth to line up correctly. The misalignment can cause:

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

The surgery may also be done to repair cosmetic problems. This may include receding chin, protruding jaw, or lips that don’t meet. It may also be done to repair problems from:

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

What to Expect

Prior to Procedure

The change in your jaw will require a change in the position of your teeth. To prepare your teeth for the surgery, you may have several months of dental care. Your dentist may use braces or similar tools to help shift your teeth into the correct position.

Closer to your surgery, you may have x-ray and models of your teeth done. This will help guide surgical work.

Talk to your doctor if you take any medications, herbs, or supplements. You may be asked to stop taking some medications 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 procedure will depend on your specific needs. Most incisions will be made inside the mouth. Some incisions may need to be made outside of the mouth.

The specific work done on the bones will depend on your needs. Some steps may include:

• Removing a section of bone
• Separating a portion 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 special liquid that acts like glue. Gauze may be placed over the surgical wounds. The gauze will stay in place for a few hours after surgery. Rubber bands may also be used with a dental appliance. They will help keep your jaw in alignment until your jaw heals.

Immediately After Procedure

After the operation, you will be taken to the recovery room for observation. 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 changes made to your jaw. It may be 2-4 hours.

How Much Will It Hurt?

Anesthesia prevents pain during surgery. As you recover, you may have some pain. Your doctor will give you medication to 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 be asked to start with a modified diet. Depending on the details of your surgery, your doctor may recommend just liquids at first or soft solids. You will be given a schedule to work back toward your normal diet.

You will be able to notice cosmetic change right away. Your jaw will need to heal before you can do normal movements. As a result, it may take some time to feel the improvements in bite or jaw movement.

At Home

Certain activities will need to be avoided until the jaw is healed. You will be instructed on how to care for the incision site to prevent infection. Dietary changes may be need to be maintained at home until the doctor says it is okay to return to a normal diet. A dietitian will help with meal planning.

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.