Real patient results How much does it cost? Book a consultation Read our FAQs
Woollahra Sydney . Wollongong NSW
Classification of Jaw Abnormalities
The jaw consists of an upper and lower part. The upper part, or maxilla, holds the upper set of teeth. The lower part, called the mandible holds the lower set of teeth. The alignment of the upper and lower parts together determines how your jaw looks.
For example, if your lower teeth are in front of your upper teeth when you close the jaw, then it might be caused by an over-protruding lower jaw (prognathism) or under-protruding upper jaw. Moreover, the alignment and protrusion of the teeth also play an important role.
As such, jaw shape abnormalities treated by Orthognathic Surgery can be classified into:
- Class I: when the upper and lower jaw are in a harmonious relationship and the lower first molar is just in front of the upper first molar
- Class II: when the lower jaw appears retracted and your upper teeth are in front. This can be caused by an over-protruding upper jaw, or under-protruding lower jaw – also called “retrognathism”
- Class III: when your lower jaw and teeth are protruding in front of the upper teeth – the lower teeth are too forward. This can be caused by under-protruding upper teeth or an over-protruding lower jaw – also called “prognathism”
“Prognathism” and “retrognathism” are used when the problem is exclusively in the lower jaw.
Other concerns with the jaw bones’ width, size, and shape also play an important role in determining your facial aesthetics. This is why Orthognathic Surgery is planned on a case-by-case basis.
When Is Jaw Surgery or Orthognathic Surgery Required?
Jaw shape and alignment abnormalities may cause both cosmetic and functional problems. As such, you may be considered a good candidate for corrective jaw surgery if you have:
Cosmetic concerns
- Overbite
- Underbite
- Crossbite
- Small chin
- Broad or wide face
- Disproportionate smile
- Unsatisfactory facial profile (chin protruding or receding)
- Overprotruding teeth
- Underprotruding teeth
- Anaesthetic smile
Functional concerns
- Temporomandibular joint (TMJ) pain
- Snoring
- Sleep apnoea
- Problems with chewing
- Problems with speech and pronunciation
- Problems with biting food
- Teeth degeneration
- Lips don’t fully close
Corrective Jaw Orthognathic Surgery is planned according to your specific anatomy and specific concerns. In addition to functionally improving your bite and mouth function, it is designed to alter the appearance of the jaw. By addressing the alignment of the teeth, chin, and other facial features, your face will look more proportional – front and profile.
Why Patients Might Consider Orthognathic Surgery
Corrective Surgery of the jaw addresses both the shape of your jaw and face, as well as several oral functions that might be concerning you. As such, patients might seek out Orthognathic Surgery for many reasons, including:
- Helping to fix an overbite, underbite, crossbite, and small chin
- Improving speech and pronunciation
- Improving biting, chewing, and swallowing functions
- Improving sleep apnoea and snoring symptoms
- Protecting the teeth from further damage
- Improving the smile
- Improving the front and profile appearance of the face
- Improving the chin shape and jaw/neck lines
The specific procedure you get will be planned according to your own cosmetic goals and complaints.
How Is Orthognathic Surgery Performed?
Corrective Jaw Surgery is usually done under general anaesthesia. You will be fully asleep during the procedure. You should expect to spend a night or two at the hospital for monitoring after your surgery.
Based on your individual anatomy, VPS outcomes, and cosmetic desires, Dr Maryam will perform one or more of the following surgical procedures to correct your jaw shape and alignment:
Maxillary Osteotomy
(Upper Jaw Surgery)
If the upper jaw is retracted Dr Maryam will first cut the maxillary bone above your upper teeth. She will then move the upper jaw (and teeth) forward to make it align with the lower teeth and jaw. If the upper jaw is over-protruding, the maxillary bone will be shaved to become less protruding.
Mandibular Osteotomy
(Lower Jaw Surgery)
This surgery is usually done to fix either prognathism or retrognathism due to lower jaw problems. If the lower jaw is protruding forward Dr Maryam will cut a piece of the mandibular bone and move the whole lower jaw backward to reduce its protrusion. If the lower jaw is receding, the mandible will be cut, and the whole jaw will be moved forward.
Teeth
Removal
Teeth might be removed if the jaw needs to be pushed backward. This might be necessary for class II and class III jaw misalignment.
Bone
Grafting
If the upper or lower jaw is not protruding enough, Dr Maryam will extend the jaw’s forward protrusion. To do this, she might take a piece of bone from your hip bone and implant it in the maxilla or mandible. This surgery can correct retrognathism due to an under-protruding mandible.
Genioplasty
(Chin Reshaping Surgery)
If the chin is prominent, then Dr Maryam might cut above it, remove a small piece of bone, and move the whole chin inward. Genioplasty can also aim to make the chin appear pointier. The chin can also be brought forward to become more protruding if you have a receding chin.
In addition, Dr Maryam might reshape the jaw bones in a way to fix other asymmetries, such as problems with width, alignment, and shape. When Osteotomy and Bone Repositioning are done, titanium plates/screws are used to fix the bone in its new position.
In most cases, Jaw Correction Orthognathic Surgery is done from inside the mouth – no external skin incisions. However, sometimes, a small incision at the angle of the mandible might be needed.
Recovery After Orthognathic Surgery
Recovery after Jaw Orthognathic Surgery requires some planning ahead. You’ll need to take time off work for at least 2 to 3 weeks to rest at home. Full recovery after Orthognathic Surgery needs 4 to 6 weeks on average.
During the first 2 weeks, you might experience some expected side effects. These include bleeding, facial bruising, swelling, and jaw pain. Fully opening the mouth, eating, and drinking might be a little challenging at first and require some getting used to.
In the early recovery period, you might need to commit to a fluid diet – juice, yogurt, soup. You can gradually start eating more solid foods as the weeks pass. It is not uncommon for patients to lose weight after Jaw Corrective Surgery.
You should brush your teeth consistently after Orthognathic Surgery to keep the mouth clean; however, make sure you use a soft toothbrush and brush gently. Ensure that you avoid smoking and vaping during recovery.
The swelling should significantly subside after 6 weeks of your jaw surgery, and you may start noticing a dramatic change in your facial appearance. Some swelling might persist for a few months and should eventually go away, allowing you to enjoy the full results of your surgery.
