Double jaw surgery is a complex orthognathic procedure designed to correct significant jaw misalignments. Its purpose extends to improving both bite function and overall facial balance.
Understanding Double Jaw Surgery
Double jaw surgery, formally known as bimaxillary osteotomy or orthognathic surgery, corrects misalignments of both the upper jaw (maxilla) and lower jaw (mandible) simultaneously. This differs from single jaw surgery, which addresses only one jaw. The procedure moves both jaws into proper alignment.
Oral and maxillofacial surgeons perform this surgery, working in conjunction with orthodontic treatment. The procedure aims to resize, reshape, or reposition the jawbones to resolve both functional and aesthetic issues. It is particularly beneficial for patients with severe jaw misalignment and complex bite problems that cannot be resolved through orthodontics alone.
Common Reasons for Surgery
Double jaw surgery addresses conditions and functional challenges that cannot be resolved with orthodontic treatment alone. Significant overbites, known as Class II malocclusion, or underbites, referred to as Class III malocclusion, often stem from skeletal discrepancies requiring surgical correction. Crossbites that involve underlying skeletal imbalances also often necessitate this intervention.
Facial asymmetry, where one side of the face appears noticeably different due to jaw position, is a common reason for surgery. Functional problems that impair daily activities, such as difficulty chewing, biting, or swallowing, can result from jaw misalignment. Speech impairments directly related to an improper jaw position may be improved.
Obstructive sleep apnea, a condition where breathing repeatedly stops during sleep, is often caused by a recessed or misaligned jaw that narrows the airway. Double jaw surgery can increase the posterior airway space, offering an effective treatment option for this condition. This can lead to improved breathing and more restful sleep.
The Surgical Procedure
Double jaw surgery is performed under general anesthesia in a hospital setting. The oral and maxillofacial surgeon makes incisions inside the mouth, ensuring no visible scars remain on the face. This technique provides access to the jawbones for repositioning.
The procedure involves cutting the jawbones, a process known as osteotomy. For the upper jaw, a Le Fort I osteotomy is performed, separating the upper jaw from the skull. The lower jaw procedure involves a sagittal split osteotomy, which cuts the back of the jaw diagonally.
After cuts are made, the jawbones are repositioned according to a surgical plan. This plan is developed using 3D imaging and virtual surgical planning, allowing for simulation of the movements. Once the jaws are in their new, corrected positions, they are secured with small titanium plates and screws, which remain in place permanently.
Recovery and What to Expect
The initial recovery period after double jaw surgery involves managing post-operative symptoms. Patients can expect swelling, bruising, and discomfort, which are most pronounced in the first few days and weeks. Swelling peaks within the first 48 hours and then gradually subsides over several weeks, though it may take up to a year to fully resolve. Pain is managed with prescribed medications.
Dietary progression is an aspect of recovery. For the first few weeks, a liquid diet is necessary, transitioning to soft foods between five and eight weeks post-surgery. Chewing functions gradually return, with patients able to introduce a wider variety of foods by four to six months. Maintaining oral hygiene is important, involving frequent gentle brushing and rinsing with warm salt water.
Initial healing is around six to eight weeks, during which patients can resume normal activities. Full recovery can extend over several months, as tissues adapt and remaining swelling dissipates. Follow-up appointments with the surgeon and orthodontist monitor healing and ensure proper alignment, including continued orthodontic treatment to achieve final results.