Definition and Overview
Also referred to as orthognathic surgery, jaw correction is a surgical procedure performed to repair or restore a faulty or problematic jaw, which can be caused by a congenital abnormality, poor development, or misalignment due to overuse or physical trauma. This condition can cause a series of problems including pain, wrong bite, and health conditions like obstructive sleep apnea, a sleeping disorder characterized by gaps in breathing, which makes it dangerous. It may also cause temporomandibular joint (TMJ) disorder, which causes pain, headaches, and swelling of the face. It is also linked to bruxism (grinding of the teeth), ear pain (since a part of TMJ is close to the ear), toothache, and difficulty in chewing.
Who Should Undergo and Expected Results
The following are candidates for jaw correction:
- Individuals who regularly have toothaches, headaches, and pain around the jaw area, especially when chewing
- Those who exhibit a severe case of bruxism
- People who have congenital misaligned jaws
- Individuals who suffer from physical trauma (e.g., falling and hitting one’s face on a hard surface or a vehicle collision impact), which may result in broken or misaligned jaw
- Those who exhibit symptoms of sleep apnea such as snoring
- People who have trouble with speech with no other manifestation of an underlying disease
It may also be performed for cosmetic reasons such as improving a receding chin, as well as after a cleft palate surgery.
The surgery is expected to repair the jaw, making sure that it goes back to its original or correct position.
How Does the Procedure Work?
Before the patient goes through the surgery, he needs to go through an intensive consultation with a maxillofacial surgeon who works with an orthodontist, a type of dentist that specializes on oral appliances such as braces.
Aside from a review of the medical records and interview, the surgeon will also conduct thorough tests, including X-rays that show the current position of the jaw, particularly in respect to the position of the teeth and other parts of the face and mouth. Once the initial dental evaluation is complete, the treatment plan is laid out.
The surgical process is divided into different phases. In the first phase, the orthodontist obtains a dental impression prior to the procedure so the lab can create braces. These braces will see to it that the upper and/or lower teeth are aligned to the jaw. Depending on the anticipated movement of the teeth, some of the existing teeth may have to be removed.
This is followed by surgery, which is performed under general anesthesia. Wire hooks or surgical wires will be attached to the jaw to make sure the teeth won’t move during the procedure.
The surgeon may work on either the maxilla (upper jawbone) or the mandible (lower jawbone), although in some instances, both are adjusted. The surgeon uses tools such as surgical saws to perform osteotomy or the cutting of the bone. A part of the bone may be removed or repositioned depending on the end goal. A steel plate or screw is then used to join the bones together.
Once the surgery is complete, the incisions are closed. Since the incisions are made not on the skin but inside the mouth, scarring is hardly visible.
Braces may have to be adjusted and worn until the correct alignment of the teeth and jaws is achieved.
Possible Risks and Complications
There will be swelling, discomfort, and pain during the first few days after the surgery. The patient may have to avoid strenuous activities and eat an all-liquid diet during the early days of recovery.
The surgery may also cause bleeding and infection, which sets in when pathogens enter the body through the wound site. In rare cases, jaw correction can cause facial nerve damage.
Journal of Oral and Maxillofacial Surgery
Taub DI, Jacobs JMS, Jacobs JS. Anthropometry, cephalometry, and orthognathic surgery. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 16.