Our Summary

This research paper looks at the long-term effects of a specific type of jaw surgery (double-jaw orthognathic surgery) on patients with a particular type of jaw misalignment (hyperdivergent Class III malocclusion). The surgery involves rotating the jaw in a counterclockwise direction to correct the misalignment.

The study followed 15 adult patients for an average of four years after their surgery. It found that the majority of patients (10 out of 15) had very stable results, with their jaw alignment remaining largely unchanged. However, four patients experienced some instability, with their jaw alignment changing slightly.

The researchers concluded that this type of surgery generally results in stable long-term outcomes for patients with this specific type of jaw misalignment. However, they also noted that the angle of the mandible (the lower jaw bone) was the most likely to change after surgery, suggesting this area may be prone to relapse.

FAQs

  1. What is double-jaw orthognathic surgery and what type of jaw misalignment does it correct?
  2. What is the long-term stability of this type of surgery according to the research?
  3. What part of the jaw is most likely to change after the surgery according to the study’s findings?

Doctor’s Tip

One helpful tip a doctor might tell a patient about jaw surgery is to follow post-operative instructions carefully to ensure proper healing and stability of the jaw. This may include avoiding hard or chewy foods, practicing good oral hygiene, attending follow-up appointments, and using any prescribed medications or appliances as directed. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can also contribute to successful outcomes after jaw surgery.

Suitable For

Patients who are typically recommended for jaw surgery are those with severe jaw misalignments that cannot be corrected with orthodontic treatment alone. This includes patients with:

  1. Severe overbites or underbites that affect their ability to eat, speak, or breathe properly.
  2. Facial asymmetry that affects their appearance and self-confidence.
  3. Difficulty chewing or biting due to jaw misalignment.
  4. Temporomandibular joint (TMJ) disorders caused by jaw misalignment.
  5. Sleep apnea or other breathing problems related to jaw position.
  6. Chronic jaw pain or headaches caused by jaw misalignment.
  7. Inability to close their lips together comfortably.
  8. Open bites or crossbites that affect their bite alignment.

It is important for patients to undergo a thorough evaluation by a qualified oral and maxillofacial surgeon to determine if they are good candidates for jaw surgery. The decision to undergo jaw surgery should be based on the severity of the misalignment, the patient’s overall health, and their willingness to undergo the surgical procedure and recovery process.

Timeline

Before Jaw Surgery:

  1. Patient consults with a maxillofacial surgeon to discuss their jaw misalignment and potential treatment options.
  2. Patient undergoes a series of orthodontic treatments to prepare their teeth for surgery.
  3. Patient undergoes pre-surgical assessments, including x-rays, CT scans, and dental molds, to create a treatment plan.
  4. Patient undergoes double-jaw orthognathic surgery to correct their jaw misalignment.
  5. Patient spends several days in the hospital recovering from surgery.
  6. Patient follows a strict post-operative care plan, including a liquid diet and pain management.

After Jaw Surgery:

  1. Patient experiences swelling, pain, and limited jaw movement in the immediate post-operative period.
  2. Patient gradually resumes a soft diet as their jaw heals.
  3. Patient attends follow-up appointments with their surgeon to monitor their progress and adjust their treatment plan if necessary.
  4. Patient continues orthodontic treatment to fine-tune their bite and alignment.
  5. Patient may experience changes in their facial appearance as their jaw settles into its new position.
  6. Patient undergoes long-term follow-up appointments to monitor the stability of their jaw alignment.

What to Ask Your Doctor

Some questions a patient should ask their doctor about jaw surgery based on this research paper include:

  1. What specific type of jaw misalignment do I have, and is double-jaw orthognathic surgery the best option for correcting it?
  2. How does rotating the jaw in a counterclockwise direction during surgery help to correct my misalignment?
  3. What are the potential long-term effects of this type of surgery, particularly in terms of stability and relapse?
  4. How many patients have you treated with this type of surgery, and what has been the overall success rate in terms of long-term outcomes?
  5. What measures can be taken to minimize the risk of instability or relapse after surgery, particularly in the angle of the mandible?
  6. Are there any alternative treatment options that may be more suitable for my specific case?
  7. What is the expected recovery process like after surgery, and what kind of follow-up care will be required?
  8. Are there any potential complications or risks associated with this type of surgery that I should be aware of?
  9. How soon after surgery will I be able to resume normal activities, such as eating and speaking?
  10. Can you provide me with any before-and-after images or case studies of patients who have undergone similar jaw surgeries to get a better idea of the potential results?

Reference

Authors: Acar YB, Erdem NF, Acar AH, Erverdi AN, Ugurlu K. Journal: J Oral Maxillofac Surg. 2018 Sep;76(9):1983-1990. doi: 10.1016/j.joms.2018.03.005. Epub 2018 Mar 15. PMID: 29625030