Our Summary

This research paper discusses the effectiveness of orthognathic surgery, which is a type of jaw surgery, as a primary treatment for temporomandibular disorders (TMDs), which are problems affecting the jaw joint and chewing muscles. The paper notes that there isn’t much solid clinical research to support using this surgery as the main way to manage TMDs. The research that does exist is often flawed or biased. Some studies have shown that the surgery can help reduce TMD symptoms in certain patients with specific jaw alignment issues (Class III and Class II). However, a specific type of corrective procedure for Class II conditions, which involves rotating the lower jaw in a counter-clockwise direction, actually made TMD worse. The paper also highlights that it’s hard to predict how a patient’s TMD will respond to the surgery due to individual differences. The authors conclude that irreversible treatments like orthognathic surgery should not be the first choice for managing or preventing TMDs.

FAQs

  1. Is orthognathic surgery a primary treatment for temporomandibular disorders (TMDs)?
  2. Do studies support that orthognathic surgery reduces TMD signs and symptoms in Class II and Class III patients?
  3. Does Class II correction with counter-clockwise rotation of the mandible affect TMD?

Doctor’s Tip

A helpful tip a doctor might tell a patient about jaw surgery is to follow post-operative care instructions carefully, including proper oral hygiene, diet restrictions, and physical therapy exercises. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, be patient with the healing process as it may take time for full recovery and optimal results to be achieved.

Suitable For

Patients with severe skeletal malocclusions, such as Class III or Class II malocclusions, are typically recommended for jaw surgery. These patients may experience difficulty with chewing, breathing, speaking, and facial aesthetic concerns due to the misalignment of their jaws. Jaw surgery can help to correct these issues and improve the overall function and appearance of the patient’s jaw and face. Additionally, patients with temporomandibular disorders (TMDs) may also be recommended for jaw surgery in some cases, although the evidence supporting this treatment approach is limited and controversial. It is important for patients to consult with a qualified oral and maxillofacial surgeon to determine if jaw surgery is the right treatment option for their specific condition.

Timeline

Before jaw surgery:

  1. Patient consults with an orthodontist and maxillofacial surgeon to discuss treatment options for their jaw misalignment.
  2. Orthodontic treatment begins to align the teeth and prepare the jaw for surgery.
  3. Pre-surgical orthodontic planning and imaging are conducted to create a treatment plan.
  4. Patient undergoes pre-surgical evaluations and tests to ensure they are a good candidate for surgery.
  5. Surgery date is scheduled, and patient is informed of pre-operative instructions.

After jaw surgery:

  1. Patient undergoes the surgical procedure, which may involve moving the upper jaw, lower jaw, or both to correct the alignment.
  2. Recovery period begins, with patients experiencing swelling, discomfort, and difficulty eating and speaking.
  3. Follow-up appointments with the surgical team and orthodontist are scheduled to monitor healing and adjust orthodontic treatment as needed.
  4. Over time, the swelling and discomfort subside, and the patient begins to see improvements in their jaw alignment and bite.
  5. Orthodontic treatment continues to fine-tune the bite and ensure long-term stability of the surgical correction.
  6. Patient may experience improved function, aesthetics, and overall quality of life as a result of the jaw surgery.

What to Ask Your Doctor

  1. What specific type of jaw surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and post-operative care plan?
  4. How will my bite and facial appearance be impacted by the surgery?
  5. Will I need to follow up with any additional treatments or therapies after the surgery?
  6. Are there any alternative treatment options to consider before proceeding with jaw surgery?
  7. How experienced are you in performing this type of jaw surgery?
  8. Can you provide me with information about the success rates of this surgery for patients with similar conditions?
  9. Are there any long-term effects or considerations I should be aware of before undergoing jaw surgery?
  10. Can you refer me to a specialist or another healthcare provider for a second opinion?

Reference

Authors: Dolwick MF, Widmer CG. Journal: Oral Maxillofac Surg Clin North Am. 2018 Aug;30(3):303-323. doi: 10.1016/j.coms.2018.04.007. Epub 2018 Jun 1. PMID: 29866451