What Is Maxillary Advancement Surgery? A Procedure Overview

Maxillary advancement surgery is a specialized procedure designed to reposition the upper jaw. This procedure aims to correct structural imbalances in the facial skeleton. It serves to improve both the functional aspects of the jaw and overall facial appearance. The procedure adjusts the position of the upper jaw to achieve a more balanced alignment.

What is Maxillary Advancement?

Maxillary advancement is a form of orthognathic surgery, which focuses on correcting conditions of the jaw and face related to structure and growth. The procedure involves moving the maxilla forward and sometimes upward. The maxilla is a large, immobile bone located in the middle of the face that houses the upper teeth and contains the maxillary sinuses.

The objective of maxillary advancement is to establish proper alignment between the upper and lower jaws, which is referred to as occlusion or bite. When the upper jaw is recessed or positioned incorrectly, it can lead to a misalignment that affects how the teeth meet. By repositioning the maxilla, surgeons aim to improve chewing and speaking abilities, and achieve greater facial symmetry.

Why Maxillary Advancement is Performed

Maxillary advancement surgery is performed to address various functional and aesthetic concerns from an improperly positioned upper jaw. One common reason is a severe underbite, or Class III malocclusion, where the lower jaw protrudes significantly beyond the upper jaw. Correcting this skeletal disharmony helps align the teeth and jaws for a more effective bite.

The procedure also offers benefits for individuals suffering from obstructive sleep apnea (OSA). A recessed upper jaw can contribute to a narrowed airway, leading to breathing difficulties during sleep. By moving the maxilla forward, the procedure helps enlarge the airway space, reducing obstruction and improving breathing. Maxillomandibular advancement, which involves both jaws, is particularly effective for OSA.

Difficulties with chewing and speaking are also common indications for this surgery. When the upper and lower jaws do not align correctly, it can impede the ability to chew food comfortably or form certain speech sounds clearly. Repositioning the maxilla can improve these oral functions. Furthermore, significant facial asymmetry or midface deficiency, where the middle part of the face appears sunken, can be addressed. Advancing the upper jaw can create a more balanced facial profile and improve aesthetics.

The Maxillary Advancement Surgical Process

Maxillary advancement surgery begins with pre-surgical planning involving an oral and maxillofacial surgeon and an orthodontist. Initial consultations include a thorough examination, X-rays, facial photographs, and dental impressions to evaluate the jaw and facial structure. This assessment helps determine if the patient is a suitable candidate for the procedure.

Advanced imaging techniques, such as CT scans and 3D virtual surgical planning, are used to design the precise movements of the jawbones. This virtual simulation allows the surgical team to visualize adjustments and plan the procedure with accuracy. Patients may also undergo orthodontic treatment, often involving braces, for several months to a year before surgery to align their teeth in preparation for jaw repositioning. Medical evaluations, including blood tests, ensure the patient is healthy for general anesthesia.

The surgery is performed under general anesthesia. Incisions are made inside the mouth, above the upper teeth, to access the jawbone, avoiding visible external facial scars. The surgeon cuts the upper jawbone in a controlled manner, a procedure known as an osteotomy. The maxilla is then moved into its planned new position. Small titanium plates and screws stabilize the repositioned jawbone. After the jaw is fixed, the internal incisions are closed with dissolvable sutures. Patients spend one to three nights in the hospital for post-operative monitoring.

Recovery and Long-Term Outcomes

Following maxillary advancement surgery, patients can expect an initial recovery phase with swelling and discomfort. Swelling and bruising are common, peaking within 48 to 72 hours and gradually subsiding over one to three weeks. Pain medication will be prescribed to manage discomfort. Patients are instructed to maintain a strictly liquid or soft-food diet for four to six weeks to allow the jawbones to heal.

Oral hygiene is also a focus during recovery, with specific instructions for gentle cleaning of teeth and surgical sites. While initial jaw stiffness is expected, patients gradually regain the ability to chew and speak more normally over several weeks. Most individuals can return to work or school within two to three weeks, though complete bone healing takes several months, between six to twelve months.

Long-term outcomes of maxillary advancement surgery include improvements in bite function, making chewing more efficient. Many patients report enhanced breathing, particularly those who underwent the procedure for obstructive sleep apnea. Speech clarity also improves as the jaw alignment is corrected. From an aesthetic perspective, the surgery can lead to a more balanced facial appearance. Ongoing orthodontic treatment, such as continued use of braces or aligners, is required after surgery to fine-tune the bite and achieve optimal dental alignment.

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