Corrective Jaw Surgery and Other ProceduresDr Sanchaita Kohli
Corrective jaw surgery or orthognathic surgery is a reconstructive surgery correcting jawbone abnormalities. It also realigns the teeth and jaws to enhance their function. Rectifying these abnormalities upgrades your facial appearance while improving function.
Orthognathic surgery overall corrects existing imbalances and abnormalities of the jaw. It fixes problems related to the following jaw functions:
- Biting and chewing
- The abnormal wear and attrition of teeth
- Jaw closure
- Open bite
- Facial asymmetry
- Pain due to Temporo-mandibular joint (TMJ) disorders
- Facial injury and congenital deformities
- Obstructive sleep apnoea
These are a few conditions where this versatile surgery offers remarkable solutions. However, it is imperative to know which surgery you need for the best results.
Types of Corrective Jaw Surgery
Orthognathic surgery has evolved as a routine part of maxillofacial surgery. However, based on the target sites of surgery, it is categorised further. Here, we have discussed the different types of corrective jaw surgery along with a brief description of the procedure.
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This includes surgery of your upper jaw or maxilla. Various conditions require a maxillary osteotomy. These are:
- Upper jaw protrusion
- Excessively gummy smile (vertical maxillary excess)
- Open bite, i.e. a condition when your teeth do not completely contact each other
- Crossbite, which is a reverse overlap of the upper and lower teeth
- Midfacial hypoplasia; reduced growth in the middle portion of your face
- Asymmetrical upper jaw (difference in upper jaw height on right and left sides of the face)
Procedure: Your surgeon makes an incision in the gums beyond your upper teeth to access the bones of your upper jaw. The bone is then surgically detached from the facial skeleton and mobilised for repositioning. The repositioning is done to achieve proportionate and balanced tooth and jaw alignment. Using titanium plates and screws, the jaw is then fixed and stabilised in this new and desirable position. The incision is then closed with absorbable stitches.
This corrective jaw surgery improves your mandible or lower jaw position. It is done when your mandible is either significantly projected forward, extremely short or asymmetrical.
Procedure: Your surgeon gives an incision on either side of the lower jaw right behind the molar teeth inside the mouth. They then cut and move the lower jaw bone forward, backwards or sideways, as needed. Once repositioned, mini-screws and titanium plates fix the bone in place, and the incision is then closed.
Bi-Maxillary Osteotomy or Double Jaw Surgery
The surgery is performed on both your upper and lower jaws and can correct jaw alignment, size, facial balance and asymmetry and improve jaw functions. Depending on the deformity, your surgeon repositions your maxilla and mandible. They may also alter the height of the jaws by removing a part of the bone.
Procedure: The techniques used are similar to those of maxillary and mandibular osteotomy procedures.
Genioplasty is a chin repositioning and reshaping surgery. It can correct a receded chin or extended chin, modify the chin’s height and ensure it remains symmetrical to the rest of the face. It is often combined with a maxillary and / or mandibular osteotomy.
Procedure: The surgeon proceeds with an incision in your gums encircling your lower lip. Through this, they can separate the chin from the lower jaw and reshape and reposition carefully. Expert maxillofacial surgeons in Delhi use the Piezotome for this process, fixing your new chin in place with titanium plates and screws.
Temporomandibular Joint (TMJ) Surgery
The temporomandibular joint (TMJ) is a hinge-joint between your jawbone and skull. The TMJ allows overall jaw movements involving chewing, talking, biting, and all mouth activities. TMJ disorders cause pain, stiffness, and restricted mobility in the Temporomandibular joint.
Your surgeon modifies the TMJ corrective jaw surgery based on the severity of disorders, using the following:
- Arthrocentesis: This minimally invasive technique involves injecting fluid into the TMJ, thus lubricating the joint and removing any debris or remnants of the infection.
- Arthrotomy: An open joint, invasive surgery through an incision in front of the ear. Your surgeon replaces or removes the affected TMJ constituents an.
Distraction osteogenesis is a bone lengthening surgery. It is an established procedure for bone and soft tissue regeneration in bone deficiency disorders in the facial region. It involves cutting the bone, and gradually pulling apart the cut ends to permit prolonged bone healing across the gap.
This corrective jaw surgery synthesises new bone through lengthening the cut bone. This technique is based on the basic bone healing properties by inciting bone healing cells or callus regeneration.
Distraction osteogenesis is applied in treatments for cleft palate patients, mandibular hypoplasia or micrognathia, maxillary hypoplasia, post fracture deformities and furthermore.
Procedure: It is a two-phase surgery. The initial phase is to insert and fix the distractor device, followed by gradual traction after the surgery. The second phase involves removing the device, once the desired bone length is achieved and the bone has gained sufficient strength.
Distraction osteogenesis as part of Corrective jaw surgery begins with an incision on the target bone followed by an osteotomy, or a surgical division of the bone, across which the distractor device is placed and fixed with screws. The device is biocompatible, sterile and lightweight.
Gradual activation of the device starts within a few days, resulting in bone regeneration and lengthening. The activation process persists for a few days, depending on the extent of the deformity. Once the effect is attained, the distractor is removed surgically.
Postoperative Care and Recovery After Corrective Jaw Surgery
The postoperative period is a prime determinant of speed of recovery. An expert surgeon with strict adherence to their guidelines is pivotal for a smooth, complication-free recovery. You are likely to have mild swelling, numbness and nasal congestion that regress during healing.
Your surgeon prescribes various antibiotics and analgesics to ease symptoms. You are expected to maintain strict oral hygiene with regular saline washes, alongside a temporary liquid diet. Recovery happens within 6-8 weeks after your corrective jaw surgery.
One major perk of the procedures discussed above is the intraoral incision and, consequently, the lack of visible scarring on your face. Since the incision happens inside the mouth, the resulting scar is also inside, ensuring this reconstructive procedure does not leave any aesthetic hindrances.
However, such excellent results are only possible with an expert maxillofacial surgeon in Delhi like Dr. Sanchaita Kohli. Using state-of-the-art facilities and techniques, Dr. Kohli promises scar-free corrective jaw procedures that enhance your jaw appearance and function with minimal pain and a comfortable recovery!
Dr. Sanchaita Kohli
Oral and Maxillofacial Surgeon
Dr. Sanchaita Kohli is an Oral and Maxillofacial Surgeon with over 13 years of training and work experience at the country’s leading dental institute, Maulana Azad Institute of Dental Sciences, enabling her to plan and manage an extremely wide variety of craniofacial deformities, jaw diseases and facial trauma.