Our Summary

This research paper discusses a method in orthognathic (jaw) surgery, where the mandible (lower jaw) is operated on first. This method is compared to bimaxillary surgery, which involves operating on both the upper and lower jaw.

Two specific surgical techniques are discussed: bilateral sagittal split osteotomy, which involves splitting the lower jaw in two, and Le Fort osteotomy, which refers to a group of surgical procedures used to correct issues with the upper jaw.

The study examines the sequence of these procedures and their effects on the outcome of the surgery. It is important in helping surgeons understand the best strategies and techniques for performing successful jaw surgery.

FAQs

  1. What is bilateral sagittal split osteotomy?
  2. What does the term “mandible first” mean in the context of jaw surgery?
  3. Can you explain the surgical sequence in orthognathic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about jaw surgery is to follow all post-operative care instructions closely, including maintaining proper oral hygiene, eating soft foods, and attending all follow-up appointments. This will help ensure a successful recovery and optimal results from the surgery.

Suitable For

Patients who may be recommended for jaw surgery include those with:

  1. Severe malocclusion or misalignment of the jaws
  2. Facial asymmetry
  3. Difficulty chewing or biting
  4. Breathing problems due to a narrow airway
  5. Sleep apnea
  6. Temporomandibular joint (TMJ) disorders
  7. Excessive wear or damage to the teeth
  8. Cleft lip and palate
  9. Obstructive sleep apnoea
  10. Tumor or trauma affecting the jaw.

It is important for patients to undergo a thorough evaluation by an orthodontist and oral and maxillofacial surgeon to determine if jaw surgery is necessary and appropriate for their specific condition.

Timeline

Before jaw surgery:

  1. Consultation: The patient meets with a maxillofacial surgeon to discuss their concerns and goals for surgery.
  2. Pre-surgical preparation: The patient undergoes a series of tests and examinations to determine their candidacy for surgery, including dental impressions, X-rays, and possibly a CT scan.
  3. Orthodontic treatment: The patient may undergo orthodontic treatment to align their teeth and prepare for surgery.
  4. Surgical planning: The surgeon creates a detailed plan for the surgery, including the specific procedures that will be performed.
  5. Pre-operative instructions: The patient receives instructions on how to prepare for surgery, including fasting guidelines and medication instructions.

After jaw surgery:

  1. Recovery: The patient wakes up in the recovery room and is monitored closely for any complications.
  2. Pain management: The patient is given pain medication to manage discomfort after surgery.
  3. Swelling and bruising: The patient may experience swelling and bruising in the days following surgery, which typically resolves within a few weeks.
  4. Diet modification: The patient may be restricted to a soft or liquid diet for a period of time after surgery to allow the jaw to heal.
  5. Follow-up appointments: The patient will have several follow-up appointments with the surgeon to monitor healing and make any necessary adjustments.
  6. Orthodontic treatment: The patient may continue with orthodontic treatment to further align their teeth post-surgery.
  7. Long-term results: Over time, the patient will experience improved facial symmetry, alignment of the jaw, and a more balanced bite.

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. How long is the recovery period for this surgery and what can I expect during that time?
  4. Will I need to follow a special diet or make any lifestyle changes after the surgery?
  5. How will this surgery affect my facial appearance and function?
  6. Are there alternative treatments available for my condition?
  7. What is the success rate of this surgery for patients with similar conditions?
  8. How many times have you performed this type of surgery and what is your success rate?
  9. Will I need to undergo any additional procedures or follow-up appointments after the surgery?
  10. What can I do to prepare for the surgery and optimize my recovery process?

Reference

Authors: Perez D, Ellis E 3rd. Journal: Atlas Oral Maxillofac Surg Clin North Am. 2016 Mar;24(1):45-53. doi: 10.1016/j.cxom.2015.10.004. Epub 2015 Nov 24. PMID: 26847512