Our Summary

This research paper is a guide for people who want to understand more about orthognathic surgery, which is a type of surgery that corrects conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmony, or other orthodontic problems that cannot be easily treated with braces. The article explains the goals of this surgery, the benefits, and the modern planning methods using virtual technology.

The paper also discusses the ongoing debates in the field such as whether to operate on the upper jaw (maxilla) or lower jaw (mandible) first, and the trend of doing the surgery before orthodontic treatment begins. It outlines the benefits of using bone grafting from the chin (osseous genioplasty) and fat grafting to the face as part of the procedure.

The article also touches on how the surgery can help those suffering from obstructive sleep apnea, a condition where breathing repeatedly stops and starts during sleep. It warns readers about potential complications and provides advice on how to avoid them. It concludes by focusing on the latest trends in assessing the surgery’s outcomes, particularly through patient-reported satisfaction and the psychological impact of the procedure.

FAQs

  1. What is orthognathic surgery and what conditions does it treat?
  2. What are the debates in the field regarding the order of operating on the upper or lower jaw?
  3. How can orthognathic surgery help those suffering from obstructive sleep apnea?

Doctor’s Tip

A helpful tip a doctor might tell a patient about jaw surgery is to follow all pre-operative and post-operative instructions carefully. This includes avoiding certain foods before surgery, taking prescribed medications as directed, attending all follow-up appointments, and following a soft diet after surgery to allow for proper healing. It is important to communicate any concerns or questions with your healthcare team throughout the entire process to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for jaw surgery include:

  1. Patients with severe malocclusion or misalignment of the teeth that cannot be corrected with braces alone.
  2. Patients with skeletal disharmony, where the upper and lower jaws do not align properly.
  3. Patients with facial asymmetry or abnormalities in the jaw structure.
  4. Patients with obstructive sleep apnea, where the airway is blocked during sleep due to the position of the jaw.
  5. Patients with temporomandibular joint (TMJ) disorders that cause pain, clicking, or locking of the jaw.
  6. Patients with difficulty chewing, speaking, or breathing due to jaw abnormalities.
  7. Patients with a protruding or receding jaw that affects facial aesthetics and function.

Overall, jaw surgery is recommended for patients who have significant functional or aesthetic issues related to the jaw and face that cannot be corrected with orthodontic treatment alone. It is important for patients to consult with a qualified oral and maxillofacial surgeon to determine if they are a good candidate for jaw surgery and to discuss the potential risks and benefits of the procedure.

Timeline

Before jaw surgery:

  1. Consultation with an orthodontist and oral and maxillofacial surgeon to discuss treatment options.
  2. Pre-surgical planning including orthodontic treatment to align teeth and prepare for surgery.
  3. Pre-surgical evaluations such as x-rays, CT scans, and 3D imaging to assess the structure of the jaw and face.
  4. Discussion of potential risks and benefits of the surgery with the surgical team.
  5. Pre-operative appointments to discuss anesthesia options and post-operative care instructions.

After jaw surgery:

  1. Immediate post-operative care in the hospital or surgical center, with monitoring of vital signs and pain management.
  2. Recovery period at home, with instructions on how to manage pain, swelling, and diet restrictions.
  3. Follow-up appointments with the surgical team to monitor healing and address any concerns.
  4. Gradual return to normal activities and diet as healing progresses.
  5. Post-operative orthodontic treatment to fine-tune the bite and alignment of the teeth.
  6. Long-term follow-up appointments to monitor the results of the surgery and address any issues that may arise.

What to Ask Your Doctor

Some questions a patient should ask their doctor about jaw surgery include:

  1. What are the specific reasons for recommending jaw surgery in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. How long will the recovery process take, and what can I expect during this time?
  4. Will I need to have orthodontic treatment before or after the surgery?
  5. How will my bite and facial appearance be improved after the surgery?
  6. What type of anesthesia will be used during the procedure?
  7. Are there any alternative treatments or procedures that I should consider?
  8. How experienced are you in performing orthognathic surgery, and how many procedures have you done?
  9. What type of follow-up care will be needed after the surgery?
  10. Can you provide me with before and after photos of previous patients who have undergone similar procedures?

It is important for patients to have a thorough understanding of the surgery, its potential outcomes, and any associated risks before making a decision to undergo jaw surgery.

Reference

Authors: Naran S, Steinbacher DM, Taylor JA. Journal: Plast Reconstr Surg. 2018 Jun;141(6):925e-936e. doi: 10.1097/PRS.0000000000004438. PMID: 29794714