Orthognathic surgery is an option for some skeletal jaw discrepancies that orthodontics alone cannot manage. Suitability, goals and risks require orthodontic and maxillofacial assessment.
Why Might Jaw Surgery Be Needed?
Jaw problems are not only an aesthetic concern; they can directly affect oral health and overall quality of life. The following conditions may indicate that you could be a candidate for orthognathic surgery:
1. Bite Problems (Malocclusion)
This occurs when the teeth and jaws do not meet correctly:
- A forward-positioned lower jaw may affect the bite and chewing.
- A deep bite is excessive vertical overlap of the upper and lower front teeth. Jaw position and dental relationships are assessed separately.
- Open Bite: A gap remains between the upper and lower teeth when the mouth is closed.
- A crossbite is a discrepancy in the transverse relationship of upper and lower teeth.
2. Temporomandibular Joint (TMJ) Problems
Joint sounds, pain and restricted movement need separate assessment. These symptoms alone do not indicate corrective jaw surgery, and surgery cannot be assumed to resolve joint pain.
3. Facial Asymmetry and Aesthetic Concerns
Facial and jaw asymmetry vary in degree. Decisions consider functional findings and risks alongside appearance goals.
The Orthognathic Surgery Process: How Do We Proceed?
The process requires assessment by an orthodontist and an oral and maxillofacial surgeon. The authorised hospital and operating team must be clarified separately.
Step 1: Diagnosis and Digital Planning
Examination findings determine the need for radiographs, cephalometric analysis or three-dimensional imaging. Digital simulation supports planning; it does not precisely predict or guarantee postoperative appearance.
Step 2: Orthodontic Preparation
Orthodontics may prepare the teeth for the planned jaw relationship before surgery. Timing and stages vary with the individual plan.
Step 3: Surgery
Surgery is performed under general anaesthesia in an appropriate hospital. Incisions are often inside the mouth; discuss the approach and possibility of scars with the surgeon.
- Upper-Jaw Surgery (Le Fort I): The upper jaw is repositioned forward, backward, upward, or downward and secured in its planned position.
- Lower-Jaw Surgery (BSSO): The lower jawbone is carefully divided and moved into the correct position.
- Chin Surgery (Genioplasty): This may be performed when the chin is significantly retruded or protruded in order to improve balance in the facial profile.
Recovery and Important Aftercare
Recovery and symptoms vary by procedure. Follow individual instructions on diet, oral care, medicines and reviews.
- Hospital Stay: A hospital stay of one or two nights is generally sufficient.
- Nutrition: A liquid diet is usually required during the first week, followed by soft foods such as purées in the subsequent weeks. This period is important for proper healing of the jawbones.
- Swelling: It may increase over the first few days and then gradually settle. Use cold packs and medicines only as instructed by the surgeon. Contact the team about increasing swelling, fever or unexpected symptoms.
- Return to daily activities and bone healing are different stages. Work, exercise and travel timing should follow surgical review.
Potential Risks
Possible risks include bleeding, infection, anaesthetic complications, bite changes and altered sensation. Numbness may be temporary or permanent. Discuss individual risks, alternatives and possible further treatment with the surgeon.
Benefits, risks and alternatives should be considered together before a decision.