Jaw Surgery Guide: Procedures, Benefits, and Risks

Who Needs Jaw Surgery? What Can It Change?

Jaw surgery, also known as orthognathic surgery, addresses various facial and functional issues. It is typically recommended for individuals experiencing problems with face shape, bite alignment, or respiratory function.

Face Shape Improvements

Common issues include a protruding jaw, misaligned teeth, a small chin, or facial asymmetry. Orthognathic surgery reshapes the lower face by repositioning the upper and lower jaw bones, effectively correcting these concerns.

Bite Correction

Many bite abnormalities can be resolved through orthodontic treatment alone. However, when issues extend beyond what braces can fix, combining jaw surgery with orthodontics optimizes both occlusion and facial aesthetics. This integrated approach often leads to better overall results compared to orthodontics alone.

Respiratory Improvements

For obstructive sleep apnea, continuous positive airway pressure (CPAP) devices are the standard treatment. For those unable to tolerate long-term CPAP use, orthognathic surgery offers an effective alternative. By advancing the upper and lower jaws, it expands the airway space, alleviating sleep apnea symptoms.

Treatment Process for Orthognathic Surgery

Treatment plans should be developed in consultation with a qualified surgeon or orthodontist, taking into account individual needs. Integrated plans generally fall into two categories, as outlined below.

The process remains similar regardless of the plan type:

• Preoperative Clinics: 3 to 4 visits for consultations, evaluations, and customized computer-simulated surgery planning.
• Hospitalization During Surgery: 2 to 4 days.
• Postoperative Follow-Up: Check-ins at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years post-surgery.

Risks of Orthognathic Surgery

While generally safe, the procedure carries potential risks that patients should be aware of.

Changes in Sensation

• Gum and Wound Area: Minor sensory nerve branches around the jaw may be affected, leading to temporary changes in sensation. Recovery typically occurs within 6 months.
• Lower Lip Sensation: During lower jaw surgery, the inferior alveolar nerve may be impacted, affecting lip sensation. Most patients regain normal function within a year, though some report subjective differences.

Titanium Hardware Exposure

Exposure of titanium plates or screws can occur months to years after surgery, with an incidence of about 1-2%. These can be removed under local anesthesia.

Wound Infection

Infections occur in roughly 1% of cases and are treated with oral or intravenous antibiotics. Severe cases may require surgical intervention.

Bleeding

Blood loss during surgery ranges from 100-1000 cc, managed immediately. The need for blood transfusions is less than 2%, and postoperative bleeding requiring intervention is under 0.5%.

Bite Issues

Occlusal positioning is guided by preoperative splints. Adjustments are rarely needed, with less than 1% requiring further surgery.