Our Summary

This research paper is a review of previous studies about the order in which jaw surgeries are done when both jaws need surgery. Usually, the upper jaw (maxilla) is operated on first, but some surgeons prefer to start with the lower jaw (mandible). The authors assessed nearly 900 abstracts and found only six that met their requirements for inclusion in the review. They found that the decision about which jaw to operate on first often depends on the surgeon’s personal preference and experience, as well as careful planning before the surgery. Though there seem to be good reasons to consider doing the lower jaw first, more research is needed to find out if this is really the best approach in terms of safety, accuracy, and patient outcomes both in the short term and the long term.

FAQs

  1. What factors influence the decision about which jaw to operate on first?
  2. Is there a consensus on whether operating on the upper or lower jaw first yields better patient outcomes?
  3. Why is there a need for more research on the order of jaw surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about jaw surgery is to follow all pre-operative instructions carefully, including any dietary restrictions and medications to avoid. It is also important to communicate any concerns or questions with your surgeon and to follow post-operative care instructions closely for a successful recovery.

Suitable For

Patients who are typically recommended jaw surgery include those with:

  1. Severe malocclusion or misalignment of the jaws
  2. Facial asymmetry
  3. Difficulty chewing or speaking due to jaw abnormalities
  4. Temporomandibular joint (TMJ) disorders
  5. Obstructive sleep apnea
  6. Birth defects affecting the jaw structure
  7. Facial trauma resulting in jaw fractures
  8. Chronic jaw pain or discomfort
  9. Aesthetic concerns related to the appearance of the jaw and facial profile

It is important for patients considering jaw surgery to consult with a qualified oral and maxillofacial surgeon who can assess their individual needs and recommend the most appropriate treatment plan.

Timeline

Before Jaw Surgery:

  1. Consultation with a maxillofacial surgeon to discuss treatment options and determine the need for jaw surgery.
  2. Pre-surgical evaluations such as X-rays, CT scans, and dental molds to assess the condition of the jaw and plan the surgery.
  3. Orthodontic treatment to align the teeth and ensure proper positioning for the surgery.
  4. Pre-surgical preparation including fasting, medication adjustments, and instructions for post-operative care.

After Jaw Surgery:

  1. Recovery period in the hospital or at home, with pain management and monitoring for complications.
  2. Gradual reintroduction of soft foods and liquids as the jaw heals.
  3. Follow-up appointments with the surgeon to monitor healing progress and make any necessary adjustments.
  4. Physical therapy or speech therapy to help with jaw function and communication.
  5. Orthodontic adjustments to maintain the new jaw position and alignment of the teeth.
  6. Long-term follow-up care to monitor for any potential complications or changes in jaw function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with jaw surgery?
  2. How long is the recovery process and what can I expect during the recovery period?
  3. Will I need to follow a special diet or make any lifestyle changes after the surgery?
  4. How will jaw surgery impact my facial appearance and function?
  5. What are the alternative treatment options to jaw surgery and why is surgery recommended in my case?
  6. How many jaw surgeries have you performed and what is your success rate?
  7. Will I need braces before or after the surgery, and for how long?
  8. How long will the surgery take and will I need to stay in the hospital afterwards?
  9. What type of anesthesia will be used during the surgery and are there any potential side effects?
  10. What are the long-term outcomes and potential complications of jaw surgery?

Reference

Authors: Borba AM, Borges AH, Cé PS, Venturi BA, Naclério-Homem MG, Miloro M. Journal: Int J Oral Maxillofac Surg. 2016 Apr;45(4):472-5. doi: 10.1016/j.ijom.2015.10.008. Epub 2015 Nov 18. PMID: 26603195