Our Summary

This research aimed to figure out if a specific type of jaw surgery (orthognathic surgery) is good or bad for people who already have issues with their temporomandibular joint (TMD), which connects your jaw to the side of your head. The researchers looked at studies from 1980 to 2016 and grouped the patients based on their specific TMD issues.

They found that the surgery reduced TMD issues in patients with a specific type of jaw misalignment (retrognathic mandible) but didn’t see a significant difference in patients who had two types of surgery (BSSO and Le Fort I osteotomy). There was a notable difference in patients with another type of jaw misalignment (prognathism) after isolated BSSO or intraoral vertical ramus osteotomy and after combined BSSO and Le Fort I osteotomy. However, there was again no significant difference after BSSO or bimaxillary surgery.

In conclusion, the surgery reduced TMD symptoms in many patients who had symptoms before the surgery, but it also caused symptoms in some patients who didn’t have any issues before the surgery. The type of TMD issues or jaw deformity a patient had before surgery did not indicate whether their TMD issues would get better, stay the same, or get worse after the surgery.

FAQs

  1. Does orthognathic surgery improve TMD issues in patients with jaw misalignment?
  2. Does the type of jaw deformity a patient has before surgery indicate whether their TMD issues will improve or worsen after surgery?
  3. Does orthognathic surgery cause TMD symptoms in patients who didn’t have any issues before the surgery?

Doctor’s Tip

A doctor might tell a patient considering jaw surgery that while the surgery can improve TMD symptoms in some patients with specific jaw misalignments, it may not have the same effect in others. It’s important to discuss the potential risks and benefits of surgery with your doctor and carefully consider whether it is the right option for you based on your individual circumstances. Additionally, post-operative care and follow-up appointments are crucial for monitoring your recovery and addressing any new or persistent TMD symptoms.

Suitable For

Typically, patients who are recommended for jaw surgery are those with severe jaw misalignments or deformities that cannot be corrected with orthodontic treatment alone. These patients may experience difficulty chewing, speaking, or breathing, as well as facial asymmetry or other aesthetic concerns. Patients with temporomandibular joint (TMJ) disorders or other jaw-related issues may also be recommended for jaw surgery if conservative treatments have not been successful in alleviating their symptoms. It is important for patients to undergo a thorough evaluation by a qualified oral and maxillofacial surgeon to determine if jaw surgery is the best course of treatment for their specific condition.

Timeline

Before jaw surgery:

  • Patient may experience jaw pain, difficulty chewing, clicking or popping in the jaw joint, headaches, facial asymmetry, and difficulty breathing or speaking
  • Patient undergoes consultations with a maxillofacial surgeon, orthodontist, and other healthcare professionals to determine the need for surgery
  • Patient undergoes pre-operative tests and imaging to assess the severity of the jaw misalignment and plan the surgery
  • Patient may need to wear braces or undergo orthodontic treatment to prepare the teeth for surgery

After jaw surgery:

  • Patient undergoes the surgical procedure, which can involve repositioning the upper jaw, lower jaw, or both to correct the misalignment
  • Patient experiences swelling, bruising, pain, and difficulty eating or speaking in the immediate post-operative period
  • Patient may need to follow a liquid or soft food diet for a period of time after surgery
  • Patient attends follow-up appointments with their surgical team to monitor healing and adjust any orthodontic appliances
  • Patient may need to undergo physical therapy or speech therapy to regain full function of the jaw and improve speech articulation
  • Patient experiences improvements in jaw alignment, facial aesthetics, and overall quality of life post-surgery.

What to Ask Your Doctor

  1. What specific type of jaw misalignment do I have, and how will the surgery address this issue?
  2. What are the potential risks and complications associated with jaw surgery?
  3. How will my TMD symptoms be affected by the surgery?
  4. Will I need any additional treatment or therapy for my TMD after the surgery?
  5. What is the expected recovery time and what should I expect during the recovery process?
  6. Are there any alternative treatments or options for addressing my jaw misalignment and TMD?
  7. How many of your patients have undergone jaw surgery for TMD, and what were their outcomes?
  8. Can you provide me with references or resources for further information on jaw surgery and TMD?
  9. How will my bite and facial appearance be affected by the surgery?
  10. How long will the results of the surgery last, and will I need any follow-up procedures in the future?

Reference

Authors: Al-Moraissi EA, Wolford LM, Perez D, Laskin DM, Ellis E 3rd. Journal: J Oral Maxillofac Surg. 2017 Sep;75(9):1835-1847. doi: 10.1016/j.joms.2017.03.029. Epub 2017 Mar 24. PMID: 28419845