Orthognathic surgery, commonly known as jaw surgery, is a procedure performed to correct irregularities of the jaw bones and realign the jaws and teeth to improve function and facial balance. Following this operation, recovery involves the use of specialized rubber bands, often referred to as elastics. These elastics are a routine part of the post-operative protocol for nearly all patients. They are instrumental in stabilizing the new jaw position and guiding the bite into its final, corrected alignment.
Purpose of Post-Surgical Elastics
The primary function of post-surgical elastics is to apply gentle, continuous force to the teeth and jaws. This force stabilizes the newly repositioned jaw segments during the initial bone healing phase. Although titanium plates and screws provide rigid internal fixation, the elastics help to fine-tune the final relationship between the upper and lower dental arches. The bands are strategically placed on hooks attached to the braces or arch wires, guiding the bite, or occlusion, into the correct position. Furthermore, they help control the surrounding jaw muscles, preventing them from pulling the repositioned jaws back toward their original position.
Standard Timeline for Elastic Wear
The duration for wearing post-surgical elastics varies widely, but a general progression is followed. Immediately after the operation, elastics are typically worn 24 hours per day for the first one to two weeks and are often non-removable. Around the two-week mark, patients transition to removing elastics for short periods, such as when eating or performing oral hygiene. As healing progresses, the total daily wear time is gradually reduced between two and six weeks post-surgery, reflecting the increasing stability of the jaw segments. The total duration of elastic wear can range from four to six weeks to several months, determined only after the surgeon and orthodontist confirm the bite is stable and the jaw bones have adequately healed.
Variables Influencing the Duration
The exact time a patient wears elastics is highly individualized and influenced by several distinct biological and mechanical factors.
Surgical Factors
The complexity and type of surgery performed is a major variable; for instance, a double jaw surgery may require a longer stabilization period compared to a single-jaw procedure. The magnitude of the surgical movement also affects stability, as larger movements increase the risk of the jaw shifting back toward its pre-surgical position.
Biological Healing
The individual rate of bone healing is another significant determinant. While rigid internal fixation with hardware secures the bones, the final consolidation of the bone segments takes time, and this healing rate differs among patients. Neuromuscular adaptation also plays a role, as the jaw muscles must learn to function correctly with the new skeletal arrangement.
Patient Compliance
The most influential factor under the patient’s control is compliance with the prescribed wearing schedule. Consistent wear is important, because part-time use of elastics will not correct the bite effectively, potentially delaying the overall treatment time.
Daily Management of Elastics
Managing the elastics requires adherence to specific instructions from the surgical team. Elastics lose their tension and effectiveness over time, so patients change them at least once a day, typically in the morning, to ensure consistent force. Patients should always carry extra packs of elastics to quickly replace any that break or are lost unexpectedly.
The elastics are usually removed for eating and for proper oral hygiene, though this instruction can vary, especially in the first week post-surgery. When removed, the patient must perform thorough brushing around the hooks and braces to prevent plaque accumulation. If an elastic breaks, it should be replaced immediately, and the matching elastic on the opposite side should also be changed to maintain symmetrical forces on the jaw. A plastic tool or tweezers can be helpful for placing the small bands, especially when the mouth opening is limited.