Our surgeons regularly provide corrective jaw surgery for individuals born with overbites or underbites. Orthognathic means “straight jaws” and the goal of orthognathic surgery is to realign the jaws so that teeth are able to come together properly. This procedure is often performed in conjunction with an orthodontist. The list below is an abridged list of the most common Jaw Alignment Surgery related topics managed by the highly trained, diverse group of specialists at HNSA. It is for patient information only and is not meant to be all-inclusive.
Benefits of Jaw Surgery
For individuals born an overbite or underbite, jaw surgery can offer a solution to the associated functional disabilities. The benefits of jaw surgery can include restoring a person’s ability to eat and chew without difficulty, improve or eliminate joint pain, and restore facial harmony and ideal dental form. Your surgeon will design your surgery using computer aided virtual planning to ensure the most precise results. We will work closely with your orthodontist before and after surgery.
Types of Jaw Surgery
- Sagittal Split Osteotomy (Lower Jaw) This procedure is performed through incisions placed inside the mouth, near where the back part of the cheek attaches to the lower jaw. The jawbone is divided in the angle of the jaw in a front-to-back plane. This allows the tooth-bearing part of the lower jaw to slide backwards, in the case of a protruding jaw, or forward in the case of a short lower jaw. Small titanium screws are then placed to hold the jaw segments together and the jaws are rubber banded for about a week following surgery.
- Le Fort 1 Osteotomy (Upper Jaw) Performed through incisions placed inside the upper lip, this procedure involves a horizontal transection of the upper jaws’ attachment to the base of the nose and sinuses. Once moved in the necessary direction, the repositioned upper jaw is held in place with tiny plates and screws. Following surgery, the jaw is rubber banded for about a week and patients are placed on a soft diet for about five weeks.
- Genioplasty (Chin) This procedure is completed through an incision on the inside of the lower lip. A horizontal cut is made in the lower jaw and the chin segment is advanced. This procedure can make a tremendous difference in facial appearance!
What to Expect from Jaw Surgery/Recovery
Jaw surgery is almost exclusively performed through incisions in the mouth, leaving the face free of any visible scars. Your surgeon will reposition the jawbones and teeth in the ideal configuration and secure them with tiny titanium plates and screws. It is expected to have facial swelling after surgery, but this usually subsides within a few weeks. You will be on a non-chew diet for 4-6 weeks while the bones heal and regain their strength.
Timeline for Orthodontics and Surgery
Our patients typically undergo a period of pre-surgical orthodontics that lasts between 6-12 months. Following surgery and recovery, patients again undergo a period of post-operative orthodontics, generally lasting between 3-12 months.
Pre-Surgery Planning
A considerable amount of planning is required prior to corrective jaw surgery. After close consultation with an orthodontist, patients will then meet for an initial surgical consultation. During this consultation, patients will be examined by the surgeon and undergo a series of photographs and radiographs in order to create a individualized treatment plan. Through our use of the latest digital imaging technology, we’re able to use computerized treatment planning, which allows the patient to better understand the functional and esthetic benefits of jaw surgery.
Surgery for Obstructive Sleep Apnea
Obstructive sleep apnea is usually due to the narrowing or collapse of the upper airway from excess or obtrusive soft tissue, hard tissue, or both. To determine the type and level of obstruction, we use our in-office 3-D CAT scanner and airway analysis software to volumetrically analyze a patient’s soft tissue, hard tissue, and airway space. This technology allows us to determine where the site of obstruction is and choose the best procedure to alleviate or cure sleep apnea symptoms. Through sleep surgery, we can increase the airway space to prevent patients from having dangerous periods of apnea, or inability to breathe, at night. This may involve removing the tonsils or the shortening of the soft palate to remove airway obstructions. Another available operation is jaw surgery. By advancing the upper and lower jaws forward, we’re able to increase the airway space behind the tongue and palate. This procedure has success rates of around 96% for curing sleep apnea.
Sleep Study
A sleep study is considered the gold standard test in identifying sleep disordered breathing and diagnosing obstructive sleep apnea. By monitoring the quality and characteristics of a patient’s sleep, brain function, and physiology in a controlled setting, our team can determine the severity of a patient’s sleep apnea and choose the best possible treatments to correct it. Sleep studies are typically conducted at a sleep center, although occasionally they are done in the comfort of a patient’s home.
Jaw Advancement
For patients whose sleeping difficulties are not resolved through other means, jaw advancement surgery may be the answer. Using osteotomies to reposition the jaw in a forward manner, we’re able to open the airway. Ideally, this procedure is also performed in conjunction with orthodontic treatment to finalize the bite. This procedure has very high success rate and is curative in over 90% of patients.
INSPIRE Therapy for Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is caused by airway collapse during sleep. The tissues of your throat relax and block the flow of oxygen to your brain and the rest of your body. Your brain senses a lack of oxygen and wakes your body up just long enough to take a breath, then falls back asleep. This cycle repeats throughout the night and results in poor sleep and damaging health effects.
Inspire Therapy is revolutionary and effective because it addresses the cause of OSA – airway collapse. It rhythmically stimulates the hypoglossal nerve – the main nerve that controls the tongue and portion of the throat muscles. The mild electrical impulse delivered by the “pacemaker” battery is timed with breathing to restore the tone in throat muscles while you are asleep, thereby preventing collapse and obstruction. The device is placed via a minimally invasive outpatient procedure.
Am I A Candidate?
Inspire therapy is an option for some, but not all sleep apnea patients. You might be a candidate for Inspire if you are:
- Diagnosed with moderate to severe obstructive sleep apnea (OSA)
- Cannot/unwilling to use and/or get consistent benefit from CPAP
- Have a BMI of 32 or under
To learn more, contact us at 503-224-1371 or request an appointment and speak with one of our jaw surgeons today!
