Jaw widening addresses discrepancies in jaw size or position to improve function and appearance. It primarily corrects alignment issues between the upper and lower arches, rather than just physical lower jaw expansion. Approaches range from non-surgical methods that guide growth or reposition teeth to surgical interventions for significant skeletal adjustments.
Reasons for Considering Jaw Widening
Interventions for jaw size or position are considered for functional and aesthetic concerns. Dental crowding, where there is insufficient space for proper tooth alignment, is a common indication. Misaligned upper and lower teeth, known as crossbites, can also prompt treatment, leading to uneven tooth wear, jaw pain, and potential speech difficulties.
Jaw asymmetry or disproportion can affect facial balance and appearance. Functional issues, such as difficulty with chewing or speaking, can arise from misaligned jaws. Problems with the temporomandibular joint (TMJ), which connects the lower jaw to the skull, can also be linked to jaw misalignment, causing pain in the jaw, face, neck, and shoulders.
Orthodontic and Growth Guidance Approaches
Non-surgical approaches focus on guiding jaw growth in younger individuals or repositioning teeth to improve alignment. In developing children and adolescents, functional appliances can influence the size, position, and relationship of the upper and lower jaws. These devices, such as Twin Blocks or Herbst appliances, encourage forward growth of the lower jaw to correct overbites and establish a balanced bite. This guidance aims to achieve better overall jaw alignment rather than directly widening the bone of the lower jaw.
Sometimes, a narrow lower jaw problem is actually a result of a constricted upper jaw. Correcting a narrow upper jaw with expanders can create harmony between the arches, indirectly resolving the apparent lower jaw issue. Orthodontic braces or clear aligners can also move individual teeth to create more space within the dental arch, to give the appearance of a wider lower jaw or improve its functional relationship with the upper jaw, without direct bone widening. These methods are most effective during active growth and have limited direct bone-widening capabilities for the adult lower jaw.
Surgical Solutions for Jaw Realignment
For adults or severe cases where non-surgical methods are insufficient, surgical interventions can correct jaw width or position discrepancies. Orthognathic surgery, also known as corrective jaw surgery, involves repositioning one or both jaws to improve alignment, function, and facial aesthetics. For the lower jaw, specific procedures like mandibular osteotomies, such as the bilateral sagittal split osteotomy (BSSO), are commonly performed. This involves making precise cuts in the lower jawbone to allow it to be moved forward, backward, or rotated into a more balanced position, then securing it with plates and screws.
Distraction osteogenesis is another surgical technique for the mandible in complex situations. This method involves surgically cutting the bone and then gradually separating the two segments over time using a specialized device, prompting new bone to form in the gap and effectively lengthening or widening the jaw. Surgery is recommended for significant skeletal discrepancies, functional impairments, or when non-surgical treatments cannot achieve the desired outcome. Orthodontists and oral and maxillofacial surgeons often collaborate closely in planning and executing these treatments to ensure optimal results.
The Path to Treatment and Recovery
The journey to jaw realignment begins with a comprehensive initial consultation with specialists, typically an orthodontist and an oral and maxillofacial surgeon. During this stage, a thorough diagnosis is established using advanced imaging techniques, such as X-rays and three-dimensional (3D) scans, to assess the skeletal structure and plan the precise movements required. This imaging allows for a customized treatment plan tailored to the patient’s anatomy and goals.
A multidisciplinary team approach is common, with orthodontists often preparing the teeth with braces before surgery to ensure they align correctly after the jaw is repositioned. Following surgical procedures, initial recovery involves about six weeks, during which swelling and discomfort gradually subside. Full healing of the jawbones can take several months (nine to twelve months). Post-treatment care includes dietary modifications, oral hygiene instructions, and continued orthodontic follow-up to maintain the achieved results.