JAW growth is a slow and gradual process, and in some instances, for unknown reasons the upper or lower jaw may not grow in a proportionate manner. A majority of these children have been seen by an orthodontist and have been undergoing therapy to help correct the bite ( Meeting of teeth ). The orthodontist can usually correct the bite if the alignment issue is related only to teeth. If the problem is related to jaw bones, then it has to be corrected by orthognathic surgery by Maxillofacial surgeons who are the only people trained to do this type of surgery.
orthognathic surgery, referred to as Jaw surgery, realigns the upper and lower jaws so that, when they are brought together, the patient's bite is aligned. Jaw surgery is also used when the jaw is out of proportion to the rest of the face.
When orthognathic surgery required:
Surgery is needed if
1. The way teeth bite together is abnormal due to the size of upper and lower jaws being different.
2. Unable to bite front teeth together which cause problems with eating and speaking, as well as appearance.
3. To treat crowded (crooked) teeth where there is a jaw size problem.
4. Jaws which look too small or too big
Initially, an orthodontist will level, align and coordinate the teeth so the surgeon can reposition the jaws with corrective surgery. The objective is to correct the abnormal meeting of teeth and jaws and to achieve harmonious facial symmetry in an esthetically pleasing manner. Patients have an improved ability to chew, speak and breathe as a result of the surgery.
Surgery is performed by at least two surgeons, following the steps that have been pre-planned on models and using mathematical algorithms. The length of the operation depends on the complexity of the case and how extensive the movement of the jaws needs to be. Orthognathic surgical procedures last anywhere from two to six hours, depending on the amount and type of surgery needed. In lower jaw surgery, the rear portion of the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as appropriate. In upper jaw surgery the jaw can be repositioned forward or backward or the jaw can be raised or lowered. Certain movements may require the jaws to be separated into several parts, with bone added or removed to achieve the proper alignment and stability. Other facial bones that contribute to the imbalance may also be repositioned, augmented or reduced in size.
After operation problems:
In general, jaw surgery is very safe and the overall satisfaction rate of patients is very high. However, as with any surgical procedure, certain risks and complications are possible. The decision to recommend surgery is not taken lightly; patient and surgeon will consider the risks, benefits and options available based on patients’s individual treatment plan before agreeing to surgery.
Patient will be discharged usually after 1 to 3 days of the surgery. X-rays are taken again after surgery.You will be seen by orthodontist after surgery.Elastic bands may be placed to hold teeth together for about 6 weeks. Patient will be shown how to remove the elastic bands for cleaning teeth and eating. It is possible to speak even with elastics in place.
Patient will have a follow-up appointment with surgeon two weeks after surgery to make sure that he or she is healing well. In addition, patient will need to continue seeing an orthodontist. Most orthodontists will remove the braces six-to-eight months after surgery.
Patient will continue to see the surgeon regularly for the first year to make sure that he or she achieves an optimal result.
- Dr. Srinivas Gadipelly
MDS, FDSRCS (London)
Maxillofacial surgeon and Professor &HOD
Maxillofacial surgery Department
Matrix hospital, Ramanthapur
Tel: 64647575, 27035678