Corrective maxilla and/or mandible jaw surgery for orthodontics is performed to rectify a broad range of major and minor skeletal and dental abnormalities, involving the misalignment of the teeth and jaws. Orthodontic jaw surgery is performed by oral and maxillofacial surgeons and can, along with correcting the positioning of the jaws, enhance speaking, breathing, and chewing. Orthodontic surgery is used to correct functional issues but can also have majorly enhancing cosmetic effects. There are nine dental specialties, including oral and maxillofacial surgery, which concentrates on complicated craniofacial cases dealing with the jaw, skull, and mouth.
When To Consider Surgical Orthodontics
In order to perform orthodontic surgery, the jaw must be done growing. Usually, jaw growth subsides around 18 years of age for males and 16 for females. The need for corrective jaw surgery ensues when one or both jaws are not in correct alignment and the proper bite cannot be acquired through orthodontic treatment alone. For some people, the upper and lower jaws may grow at different rates. Birth defects and injuries can also impact the jaw positioning and alignment. While typically orthodontics can fix a problematic bite or occlusion (problems when only the teeth are misaligned), a misalignment of the jaws may necessitate corrective jaw surgery.
When a child needs orthodontic surgery, the dentist or orthodontist will be able to tell and will refer the patient to the correct specialist. Ultimately the dentist, orthodontist, and oral and maxillofacial surgeon will all collaborate in deciding the correct care for a child and if they are a candidate for corrective jaw surgery when the jaws fully mature. Specifically, the oral and maxillofacial surgeon decides which particular corrective jaw surgical procedure is pertinent and performs the actual surgery.
Some conditions that may denote a need for corrective jaw surgery include:
- Difficulty swallowing
- Difficulty chewing or biting food
- Chronic jaw or jaw joint (TJM) pain and headache
- Chronic mouth breathing or dry mouth
- Immoderate wear to teeth
- Inequitable facial appearance from the front or side
- Birth defects or facial injury
- Protruding jaw
- Receding chin
- Open bite (space between top and bottom teeth when mouth is closed)
- Incapacity to make the lips meet without straining
- Sleep apnea (problems with breathing while sleeping, involving snoring)
How Orthodontic Jaw Surgery Works
It is essential to understand that treatment will likely incorporate orthodontics before and after corrective jaw surgery, which in full may all take several years to complete. Understanding that this is a tremendous commitment for a child and their family, the orthodontist and oral and maxillofacial surgeon will do their best to pragmatically approximate the total time required for treatment.
Corrective jaw surgery may potentially reposition a portion or all of the lower jaw, upper jaw, and chin. After being fully advised on a child’s situation and their choices for treatment, the parents and dental team will decide which course of action is best for the child. Surgery will take place in a hospital and may take several hours to complete, contingent on the particular case. After surgery, a patient will need about two weeks to rest and heal, during which time a teen will not be able to attend school. After the jaw is healed, the teen will likely need to wear braces to fix their bite for six to twelve months after surgery. After the braces are off, the orthodontist will make a custom fitted retainer for the patient to wear to help sustain their new smile.
Common Types Of Corrective Jaw Surgery
Jaw surgery may be necessary to correct the lower jaw, upper jaw, or both.
Upper jaw surgery: called a maxillary osteotomy and may be used to correct problems like:
- Open bite
- Severely receded upper jaw
- Too little or too much of the teeth showing
For upper jaw surgery, the surgeon cuts the bone above the teeth and under the eye sockets to allow the whole top jaw (including the roof of the mouth and upper teeth) to be shifted as one piece. The upper teeth and jaw are shifted forward until they correctly line up with the lower teeth. After the jaw is realigned, small screws and plates are used to keep the jaw in its new place. The screws look similar to the brackets used for braces and actually, over time, grow into the bone structure.
For an open bit specifically, the surgeon shaves away the surplus bone that forms above the molars to cause this problem. People with an open bite have an angled bone surface above the molars rather than a flat and even one, which makes chewing difficult.
Lower jaw surgery: called a mandibular osteotomy and may be used to correct a severely lower jaw. For lower jaw surgery, the surgeon cuts behind the molars and down the jawbone horizontally in order for the front of the jaw to be shifted as one piece. The jaw evenly slides to its new place, and screws keep the jawbone intact until it heals in the correct position.
Chin surgery: called a genioplasty and is used to correct a deficient chin, which typically goes hand in hand with a severely receded lower jaw. For a genioplasty, the surgeon cuts the chin bone and fastens it in a new position. Usually, surgeons can fix a receded lower jaw and restructure the chin during one surgery.
Risks Associated With Orthodontic Jaw Surgery
As with any medical procedure, there are particular risks associated with having orthodontic jaw surgery. These procedures, however, are not new, have been used for many years in hospitals and practices, and are considered very safe.
Benefits Associated With Orthodontic Jaw Surgery
Corrective jaw surgery shifts the jaws and teeth into a position that is healthier, more equitable, and functional. The outcomes of orthodontic jaw surgery can have a significant and positive effect on numerous aspects of a person’s life. Corrective jaw surgery, in many cases, improves a person’s speech and appearance as well. For most patients, it is extremely rewarding to achieve a healthy and beautiful smile that lasts. Aside from the health benefits, corrective jaw surgery helps patients smile with confidence!