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Jaw surgery, also called orthognathic surgery, corrects the jaws by means of an operation. Jaw surgery is largely achieved by dissecting the jaw in separate fragments which are then moved into new positions and fixed with plates and screws. All incisions for jaw surgery are made inside the oral cavity, avoiding any visible scarring.
Because moving the jaws also moves the teeth, jaw surgery is usually performed in conjunction with orthodontics so that the teeth are in proper position after the jaw surgery. In diagnosing your need for jaw surgery, the oral and maxillofacial surgeon and the orthodontist will work closely together. The orthodontist is responsible for moving the teeth so they will fit together properly after the jaws have been repositioned. The maxillofacial surgeon is responsible for repositioning the jaw so the teeth and jaws are in proper alignment.
Jaw surgery focuses on improving the patient’s appearance as well as the functionality of the jaws and teeth. The aim of jaw surgery is to achieve a proper occlusion (the manner in which the upper and lower teeth fit together) and a more aesthetically pleasing face.
Proper occlusion
Many malocclusions are correctable by wearing orthodontic braces alone. In some situations, however, the upper and lower jaws are of a different size or shape, or are in an incorrect relationship to one another. In this situation it will be necessary to align the jaws and the teeth. In this way the orthodontic result is not compromised and the optimum result is achieved as far as long-term stability, appearance and function are concerned.
Severe malocclusion (bad bite) may cause many functional problems. You may have already experienced some of the following:
inability to chew food properly which compromises digestion
speech problems
facial muscle dysfunction characterized by headaches, joint pain, etc.
periodontal trauma.
Functionality is increased when teeth fit together firmly, making biting and chewing food easier. Jaw surgery also alleviates the grinding and pressure associated with most oral disorders, and prevents further damage to the affected teeth.
Enhanced facial aesthetics
Patients also enjoy an enhanced facial profile after jaw surgery, since oral disorders frequently affect facial balance and aesthetics.
Some people may consider having cosmetic procedures to enhance their new appearance, such as surgery on the eyes, nose, forehead, chin or neck. You may wish to discuss these options with your surgeon.
Facial Harmony
While tastes do differ, in orthognathic theory, a number of guidelines describe what are the characteristics of an aesthetically pleasing face.
Dividing the face in thirds
Facial balance typically is assessed by dividing the face in thirds. The upper third is from the anterior hairline to the point on the midline between the eye-brows (glabella). The middle third reaches until a point immediately under the nose (subnasale). The lower third ends on the midpoint of the chin (menton). When each of the thirds is equal, the face is said to be vertically balanced and of ‘ideal’ proportions.
Dividing the face in thirds. When each of the thirds is equal, the face is said to be vertically balanced and of ‘ideal’ proportions.
Facial Convexity
Additionally, in profile view the face should have a slight degree of convexity as measured from the glabella to the subnasale to the menton. Excess facial convexity, flatness, or concavity is felt to be less ideal. Of course it has to be noted that these guidelines are only idealized concepts. They merely provide a guideline that is not true for every patient. A wide range of faces defy such absolute canons.
Ideal facial convexity
Lack of facial convexity
Excess facial convexity
Sequence of jaw surgery treatment
Combined orthodontic treatment and jaw surgery often takes considerable time to complete and therefore requires great motivation and cooperation from the patient. A close liaison between the patient, the orthodontist and the maxillofacial surgeon is also important.
