Our Summary

The research team wanted to find out which types of jaw surgery are the most reliable. They looked at findings from previous systematic reviews - studies that analyze data from numerous related studies - to determine this. They searched several online databases and also looked at lesser-known studies in Google Scholar, as well as the reference lists of the studies they found.

They ended up analyzing 15 studies, some of which were systematic reviews and others were meta-analyses (studies of studies). They assessed the quality of these studies using a tool called AMSTAR 2 and found them to be of medium to high quality. However, they noted that the studies within these reviews and analyses had a moderate to high risk of bias.

From this research, they were able to rank jaw surgeries based on their reliability. They found two surgeries to be particularly unreliable: one that involves expanding the upper jaw using semi-rigid internal fixtures at the back teeth level, and another that involves rotating the lower jaw using rigid internal fixtures with screws in a front-to-back direction.

FAQs

  1. What was the purpose of the research conducted on orthognathic surgery?
  2. How did the research team assess the quality of the studies they reviewed?
  3. Which types of jaw surgeries were found to be particularly unreliable in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about orthognathic surgery is to carefully consider the type of jaw surgery recommended, as some procedures may be more reliable than others. It is important to discuss the risks and benefits of each option with your surgeon to make an informed decision about your treatment plan. Additionally, following post-operative care instructions and attending follow-up appointments are crucial for a successful recovery and optimal results.

Suitable For

Orthognathic surgery is typically recommended for patients with severe malocclusions (misalignments of the teeth and jaws) that cannot be corrected with orthodontic treatment alone. Some common reasons for recommending orthognathic surgery include:

  1. Skeletal discrepancies: Patients with significant discrepancies between the upper and lower jaws, such as an overbite (Class II malocclusion) or an underbite (Class III malocclusion), may benefit from orthognathic surgery to reposition the jaws for improved function and aesthetics.

  2. Jaw deformities: Patients with congenital or acquired jaw deformities, such as cleft lip and palate, may require orthognathic surgery to correct the abnormal growth and alignment of the jaws.

  3. Temporomandibular joint (TMJ) disorders: Patients with severe TMJ disorders that cause pain, clicking, or limited jaw movement may benefit from orthognathic surgery to improve the alignment and function of the jaw joints.

  4. Sleep apnea: Patients with obstructive sleep apnea may benefit from orthognathic surgery to reposition the jaws and improve airway patency during sleep.

  5. Facial asymmetry: Patients with significant facial asymmetry may benefit from orthognathic surgery to improve facial harmony and balance.

Overall, orthognathic surgery is recommended for patients who have functional or aesthetic concerns related to their jaw alignment and bite that cannot be addressed with orthodontic treatment alone. It is important for patients to consult with a qualified oral and maxillofacial surgeon to determine if orthognathic surgery is the right treatment option for their specific needs.

Timeline

Before orthognathic surgery:

  1. Patient consults with an orthodontist and oral surgeon to discuss the need for surgery.
  2. Patient undergoes pre-surgical orthodontic treatment to prepare the teeth for surgery.
  3. Patient undergoes various diagnostic tests, such as X-rays, CT scans, and facial photographs.
  4. Surgical planning is done to determine the specific movements needed for the jaws.
  5. Patient may undergo psychological evaluation to ensure they are prepared for the surgery.

After orthognathic surgery:

  1. Patient undergoes the surgical procedure, which may involve repositioning the upper jaw, lower jaw, or both.
  2. Patient is monitored closely in the hospital for the first few days post-surgery.
  3. Patient may experience swelling, pain, and difficulty eating in the immediate post-operative period.
  4. Patient follows a strict post-operative care plan, including a liquid diet and oral hygiene instructions.
  5. Patient attends follow-up appointments with the oral surgeon and orthodontist to monitor healing and adjust orthodontic treatment as needed.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with orthognathic surgery?
  2. How long is the recovery period after orthognathic surgery?
  3. Will I need to follow a special diet or take specific medications after surgery?
  4. How will orthognathic surgery improve my bite and overall oral health?
  5. What type of anesthesia will be used during the surgery and are there any risks associated with it?
  6. Will I experience any changes in sensation or movement in my jaw after surgery?
  7. How long will the results of orthognathic surgery last?
  8. Are there any alternative treatments or procedures that could achieve similar results?
  9. What is the success rate of orthognathic surgery for my specific condition?
  10. How many orthognathic surgeries have you performed and what is your experience with this procedure?

Reference

Authors: Haas Junior OL, Guijarro-Martínez R, de Sousa Gil AP, da Silva Meirelles L, Scolari N, Muñoz-Pereira ME, Hernández-Alfaro F, de Oliveira RB. Journal: Int J Oral Maxillofac Surg. 2019 Nov;48(11):1415-1433. doi: 10.1016/j.ijom.2019.03.003. Epub 2019 Mar 23. PMID: 30910409