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Mandibular (jaw) correction

What is the Mandibular (jaw) correction?

Mandibular surgery is done to correct an overgrowth or undergrowth of the lower jaw. This is a very common abnormality. Sometimes, undergrowth of the mandible is related to snoring, breathing difficulties, or sleep apnea, a condition in which people experience shortness of breath that wakes them up at night.

Mandibular surgery can involve bone-moving procedures such as osteotomy (bone-cut) and distraction osteogenesis, as well as bone-grafting techniques that may use either artificial bone material or a patient's own bone, taken from elsewhere in the body. Depending on each patient's specific situation, surgery of the maxilla (upper jaw) or genioplasty (chin surgery) may also be a part of the treatment plan. Mandibular surgery may also be combined with orthodontic procedures such as braces in a long-term treatment plan.

What is the procedure?

The surgery is generally done under general anesthesia. An incision is made at the back of the mouth in the gum by the molar teeth to gain access to the jaw. The lower jaw is then cut in an oblique fashion with a small saw to allow it to be broken in a controlled manner. It is then moved into its new position, which has been predetermined during surgical planning with the aid of models of your teeth. A small plastic wafer is attached to the teeth to allow the new position of the lower jaw to be determined, which is then fixed into place with small metal plates and screws. These are made of titanium which is a very inert metal and safe to be used in the body. The gum is stitched back into place with dissolvable stitches.

What kind of result can you expect?

Corrective jaw surgery moves your teeth and jaws into positions that are more balanced, functional and healthy. After the surgery patient’s bite and function is improved, patients also experience enhancements to their appearance and speech.

Recovery period and recommendations

Patients have to maintain a no-chew diet for a period of time during recovery. Right after the surgery, many people experience facial swelling that can be severe for the first few days. Applying ice packs can bring down the major swelling, but residual swelling can take several weeks to go down. Patients may also feel some numbness in their lips, gums and/or chin for some time after the surgery.

Possible side effects and complications

With this type of surgery complications are rare, but still may include:

- bleeding. During surgery the risk of significant bleeding is low, but there is a risk of approximately 1% of needing a blood transfusion;

- numbness – your bottom lip will be numb and tingly after the operation, similar to the sensation after having an injection at the dentist. This numbness may take several months to disappear and in a minority of patients there may be some permanent changes in sensation of the lower lip;

- infection – the small plates and screws that hold your jaw in its new position are usually left in place permanently. Occasionally they can become infected and need to be removed but if this happens it is not normally a problem until several months after surgery;

- adjustment of the bite – in the weeks following surgery it is often necessary to put elastic bands on your orthodontic braces to guide your bite into its new position. Rarely a second small operation may be required to reposition the fixing plates and screws if your new bite is not quite right;

- non-union - occasionally bones don't heal as they should and if this does happen sometimes a second procedure is indicated. Problems like this are more likely to occur in smokers or in those who are immunosuppressed (e.g. diabetics).

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