Maxillofacial surgery is a medical and surgical specialty that treats various problems related to the mouth, jaw, and face. These types of surgeries not only help improve the function of the jaw and teeth, but can also create beauty in the face and facial structure. With today's advanced medical technologies and capabilities, maxillofacial surgery has become an effective solution for problems such as sleep apnea, orthodontic problems, jaw fractures, and even improving appearance. In this introduction, we will examine the details and importance of these types of surgeries
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Overview of Maxillofacial Surgery
Oral, maxillofacial surgery is an important specialty in the field of dentistry that focuses on facial reconstructive surgeries, facial trauma and accident surgery, problems of the oral cavity and adjacent areas such as the head and neck, jaws, and soft and hard tissues of the oral area.
This specialty of dentistry has a wide range of manifestations, and surgeons specializing in this field have the skills and knowledge necessary to diagnose and treat diseases, injuries, and defects of the face and mouth, as well as facial cosmetic issues. This specialty is usually performed as a team, which includes the collaboration of oral, maxillofacial surgeons and specialists in the field of orthodontics. These two specialties, which are recognized in the field of dentistry, work together to provide better treatments and surgeries for patients.
Benefits and advantages of jaw surgery
Jaw surgery has the following advantages, which can be stated as follows:
-Improving dental contact:
Jaw surgery improves the contact between the teeth. This helps to chew food properly and completely and also reduces the risk of food getting stuck between the teeth.
-Improving pronunciation:
Correcting the jaw and tooth areas improves the pronunciation of letters and words.
-Solve swallowing problems:
If you are having trouble swallowing, jaw surgery can improve these problems.
-Reduce the risk of tooth wear and breakage:
By evenly distributing the load on the teeth, the risk of tooth wear and breakage is minimized.
-Reduce pressure on the jaw joint:
Jaw surgery reduces the excessive pressure on the jaw joint, which can gradually lead to jaw joint destruction and related problems.
-Correct problems with the opening and closing of the jaws:
Problems with the opening and closing of the jaws, such as open bites and cross bites, can be corrected with jaw surgery.
-Correct facial imbalances:
Jaw surgery can improve facial imbalances or low facial symmetry.
-Easely closing the lips:
After jaw surgery, the lips close without pressure.
-Reducing pain and problems related to pressure on the muscles and jaw joint:
Headaches, jaw and neck pain caused by pressure on the muscles and jaw joint can be improved with jaw surgery.
-Repairing birth defects of the face:
Jaw surgery can correct birth defects or the effects of unsuccessful facial injuries.
-Resolving sleep apnea problems:
Jaw surgery can improve sleep apnea problems.
Traumatic injuries and their surgery
Trauma refers to any type of injury or damage that results from physical or chemical agents to body tissues. These injuries can cause numerous complications on various body tissues such as the skull, chest, abdomen, pelvis, and upper and lower limbs.
Trauma is known as the third leading cause of death in all age groups after cardiovascular diseases and cancer and is one of the most important and widespread topics in the medical field. Trauma is generally divided into three categories based on its severity, including mild, moderate, and severe trauma. Maxillofacial surgeons have the ability to treat and correct the type of trauma after diagnosing the type of trauma caused.
Maxillofacial surgery for repair and aesthetics
Jaw surgery is mainly performed to treat jaw disorders and deformities. This science, called orthognathics, aims to correct and repair jaw deformities. Jaw surgery improves the function of the jaw joints and is also considered an aspect of cosmetic surgery. This surgery simultaneously attempts to improve the function of the jaw joints and enhance the beauty of the person's face.
Who needs jaw surgery
Distinguishing a normal jaw from an unhealthy and abnormal jaw is the first step in diagnosing the need for jaw surgery. When a jaw is abnormally shaped and affects important functions such as chewing, speaking, and breathing, jaw surgery is recommended. Symptoms that usually prompt a doctor to perform this surgery include a protruding lower jaw, a protruding lower jaw, a deviated lower jaw, an absent chin, and a deviated upper jaw.
Excessive gum showing when smiling
Factors that can lead to jaw and facial abnormalities include genetic factors, congenital syndromes, and complications from trauma to the jaw and face. People who have experienced problems in their jaw and face due to various reasons such as illness or accident, etc. or who plan to undergo facial cosmetic surgery, it is better to refer to a skilled and experienced surgeon.
The goals of people who refer to a maxillofacial surgeon may be therapeutic, aesthetic, or both. Jaw surgery is also considered a type of cosmetic surgery, because it also improves the appearance of the person's face by correcting irregularities in the jaw bones.
The need for mandibular surgery
Mandibular surgery is performed to correct the following:
-Retroactivity of the mandible
-Protrusion of the mandible
-Maxillary osteotomy
In maxillary surgery, the surgeon makes incisions in the jaw and then moves the free part of the jaw, depending on the goal of the correction (forward, backward, up or down). Then, using screws and plates, the jaw is fixed in the new position.
Maxillary surgery can be performed to correct the following:
-Improper appearance of the upper jaw
-Crossbite (only in cases where the teeth are positioned abnormally in the mouth)
-When the crowns of the teeth are too far forward or too deep in the jaw
-Openbite (when the upper and lower teeth do not overlap in a closed position)
-Reduced growth in the middle of the face (midfacial hypoplasia)
In this surgery, the surgeon corrects the upper jaw in a way that corrects jaw and facial problems.
-Review of lower jaw surgery (mandibular osteotomy)
In lower jaw surgery or mandibular osteotomy, also known as mandible, we correct problems related to the lower jaw. These problems include:
-Retrogression of the lower jaw (jaw recession)
-Protrusion of the lower jaw
In this surgery, the surgeon makes incisions behind the large molars and continues these incisions down to free the front part of the jaw. The jaw can be moved forward or backward to its new position. Screws and plates maintain the health of the jaw and hold the two parts of the jaw together until bone formation is complete.
Need for chin surgery (genioplasty)
Chin surgery is performed to correct problems such as a small or backward chin. If the problem of a backward chin is accompanied by backward lower teeth and the relationship between the teeth is more difficult, lower jaw surgery is also performed at the same time. However, in cases where only the chin is backward and the relationship between the teeth is not very difficult, chin surgery is performed alone.
To move the chin forward in chin surgery, a small incision is made in the lower ridge of the chin and the chin bone is pulled forward. The chin bone is then fixed in the new position using screws, plates, or wires. Also, in cases where chins are protruding and need to be made smaller, chin surgery involves cutting the front of the chin bone and making it smaller.
Types of Oral and Maxillofacial Surgery
-Maxillofacial Fractures:
Surgery to repair fractures of the jaw and facial bones that may have been caused by accidents or trauma.
-Maxillofacial Tumors and Cysts:
Surgery to drain or destroy tumors and cysts in the jaw and facial areas.
-Corrective Facial Surgery (Orthognathic Surgery):
This type of surgery is performed to correct jaw and facial deformities, for example, correcting jaw deformities and adjusting the jaw joints.
-Jawbone Reconstruction for Implant Placement:
In cases where dental implants or dental restorations need to be placed in the jaw, jawbone reconstruction may be necessary.
-Temporomandibular Joint Disorders:
Surgery to treat temporomandibular joint (TMJ) disorders, which can lead to pain and problems in the mouth and jaw.
-Congenital defects such as cleft lip and palate:
Reconstructive surgeries to treat congenital defects such as cleft lip and palate.
-Various surgeries:
This includes a variety of surgeries that may be performed to treat mouth and jaw problems or improve facial appearance.
In fact, various surgeries are performed to diagnose and treat mouth and jaw problems and require the skills and expertise of dental surgeons.
Placing dental implants
Dental implants are metal screws that are compatible with the body and are surgically placed under the gum and into the bone of the mouth. These implants are used to replace missing or weakened teeth and improve the appearance and function of the mouth. Restorations that are performed for the purpose of facial aesthetics, including the placement of dental implants, are performed by an oral surgeon.
Corrective jaw surgery or orthognathic surgery
This type of surgery is performed by maxillofacial specialists to correct the position of the jaw and face. In this surgery, the jaw bones are cut and then the specialist corrects the deformity and jaw-dental abnormalities by changing and adjusting their position. These measures are performed to improve the function of the mouth and the appearance of the face and require the expertise and experience of maxillofacial specialists.
Surgical treatment for sleep apnea
Obstructive sleep apnea is a sleep disorder that deprives people and their loved ones of peace and restful sleep due to several factors, especially obstruction of the airways during the night. Surgery is a solution to treat this disorder. The main goal of surgical treatment of obstructive sleep apnea is to increase the air space in the airways, which is created during sleep due to sagging and narrowing. This surgery can be performed by strengthening the tissues inside the throat and correcting the position of some internal and surrounding parts of the throat. In the context of obstructive sleep apnea surgery, the focus is on parts of the mouth and throat, such as the tongue, tonsils, adenoids, upper and lower jaw.
Reconstructive or reconstructive surgery
These surgeons are able to help these people by shaving bones, realigning joints, or even rebuilding damaged cavities. If a person’s face or jaw is broken or misshapen, these surgeons are able to repair it.
Cleft lip or palate
Some birth defects can lead to cleft lip and palate. These conditions can have cosmetic and health effects on a person throughout their life. In fact, oral and maxillofacial surgeons use surgery to repair this type of birth defect.
-Skeletal problems:
Skeletal problems such as misshapen jaws can usually be corrected by most oral and maxillofacial surgeons.
-Face, Mouth, or Neck Cancer:
Maxillofacial surgeons are often consulted for the treatment of cancers of the face, mouth, and neck. These specialties provide solutions to remove tumors without harming sensitive nerves in the head and neck.
-Reconstructive surgery:
In the event of an accident or injury to the face, reconstructive maxillofacial surgery may be necessary. Some maxillofacial surgeons specialize in repairing fractures of the jaw, cheekbone, and teeth. They can also replace missing teeth with dental implants.
-Cosmetic surgery:
Finally, maxillofacial surgeons can also address cosmetic issues. If you are interested in dental implants or cosmetic changes to your face, you can seek help from these doctors to achieve your cosmetic goals.
Obstructive Sleep Apnea and Its Different Surgical Methods
There are various surgical methods to treat obstructive sleep apnea. These procedures include:
-Removal of excess tissue
-Tissue tightening
-Repositioning of the jaw
-Implants
-Nerve stimulation
-Creation of a new airway (tracheostomy)
-Weight loss surgery
-Surgery to enlarge the tonsils and adenoids
How to Prepare a Patient for Jaw Surgery
Orthodontics is usually best done before surgery. In most cases, preoperative orthodontics will attach braces to the patient's teeth. These braces should usually be attached to the teeth about 12 to 18 months before surgery to help the teeth be in the best position for surgery.
The orthodontist and oral and maxillofacial surgeon will work together to develop and implement a treatment plan. This will include taking radiographs, taking X-rays, and making 3D models of the patient's teeth. These steps are done to properly plan for jaw surgery.
Preoperative jaw surgery is usually performed by an oral and maxillofacial surgeon under general anesthesia. The procedure is performed in a hospital or a specialized maxillofacial clinic. The patient will need to stay in the hospital for about 2 to 4 days after the procedure to be monitored by the doctor.
Intraoral jaw surgery
During jaw surgery, surgery is usually performed inside the mouth, so there are no scars or incisions on the face, chin, jaw, or around the mouth. However, sometimes small incisions outside the mouth may be necessary.
The jaw surgeon makes incisions in the jawbone and moves the jaw into the correct position. After the jaw is repositioned, small screws, wires, and rubber bands are used to stabilize and fix the bones in their new position. These screws and wires, which are smaller than orthodontic brackets, gradually fuse with the jawbone.
In some cases, extra bone is added to the jaw, or grafted. The maxillofacial surgeon takes bone from areas such as the patient's pelvis, leg, or rib and attaches it to the jaw using screws. In other cases, the shape of the bone may be changed to give it a better shape.
Important steps before and after jaw surgery
-Before maxillofacial surgery
The patient usually undergoes orthodontic treatment before surgery to adjust the teeth to the ideal position for surgery. This preparation usually requires a period of about 9 to 14 months.
Jaw surgery is performed in the hospital, and the patient must stay in the hospital for 1 day after surgery.
-After maxillofacial surgery
-After surgery, the teeth and jaws may return to their previous position. To deal with this situation, orthodontic appliances are used. After about 6 to 9 months, these appliances are replaced with removable plates.
-The patient should pay attention to regular dental care after surgery. During this period, brushing the surgical areas should be avoided.
-When resting, keep your head higher than your body to reduce swelling.
-Take the prescribed medications as directed by your doctor.
-Avoid heavy physical activity to avoid complications with the surgical outcome.
-A soft diet and eating soft, liquid foods such as soup and mashed potatoes are recommended.
-These are important precautions after jaw surgery that patients should pay attention to in order to help them recover faster and return to normal.
After jaw surgery, it is very important to follow the following tips to get the best results:
-Tobacco and alcohol consumption:
Tobacco use and consumption of alcoholic beverages will delay your recovery. Therefore, you should avoid these for a while after jaw surgery.
-Medications:
Taking certain medications such as aspirin and ibuprofen during the recovery period after jaw surgery can cause more bleeding. Therefore, avoid taking these medications until you are fully recovered. Consult your doctor before taking painkillers.
-Strict Activities:
After the recovery period from jaw surgery, you can gradually resume your daily activities. However, you should still avoid strenuous activities for a while.
-Swelling and Bruising:
Swelling and bruising are normal and normal after jaw surgery. Use ice packs to reduce swelling.
-Drinks:
Avoid drinking through a straw.
-Sleep:
During the recovery period, avoid sleeping and resting on your side or stomach and sleep with your head up.
-Nutrition:
Include fluids in your diet in the first few days after surgery and gradually replace them with harder foods.
-Salt and Spices:
Eliminate or minimize salt and spice intake during the recovery period after jaw surgery.
Following these tips will help you experience a better recovery and reduce post-surgery complications.
How to eat after jaw surgery
In the first few days, the diet should be soft and without chewing. You can make the foods very soft or use a blender to make them smooth and soft. The important thing is that the food does not require chewing. For example, you can use porridge, yellow porridge, soup, soft foods and yogurt. But be sure to pay attention to the amount of food consumed so as not to damage the wounds.
-Care for three weeks after maxillofacial surgery
During this period, you do not need to consume only liquids. You can eat soft foods. These foods include mashed potatoes, scrambled eggs, omelets, ketchup and other soft foods. At this time, chewing will start to some extent again, but you still need to be careful.
-3 to 6 weeks after maxillofacial surgery
At this time, you can increase the amount of chewing, but the foods should not be hard. Take small bites. If you eat soft meat, cut it into small pieces. Each bite should be smaller so that there is less pressure on the jawbone.
You can also increase the number of meals. During this time, the jaw muscles are adjusting to the new conditions for two to three months and may tire quickly. Avoid eating foods that require long chewing or large bites.
-After six weeks
Chewing will return to normal. However, the jaw is not yet fully healed and foods should not be too hard. Avoid eating hard foods such as pizza, apples, carrots, tough meat and the like for at least three months after surgery.
Best age for jaw surgery
It is recommended to have jaw surgery after growth has stopped. For girls, the most suitable and best age for jaw surgery is usually 14 to 16 years old and for boys, the ages of 17 to 21 years old.
Conclusion
Maxillofacial surgery is a specialized procedure for correcting jaw deformities and improving facial function and aesthetics. This surgery not only has a significant impact on facial proportions and improving the smile, but also resolves problems such as chewing abnormalities, respiratory problems and chronic jaw pain. Choosing a specialized and experienced surgeon, such as the professional team at Dr. Julai Clinic, plays an important role in achieving the desired results. By utilizing the latest techniques and treatment methods, this clinic is an ideal option for those seeking successful and safe maxillofacial surgery.
Frequently Asked Questions
1. Who is maxillofacial surgery suitable for?
This surgery is recommended for people who have problems such as jaw deformities, chewing disorders, respiratory problems, chronic jaw pain or facial asymmetry. Also, patients who have severe jaw injuries or congenital abnormalities can benefit from this surgery.
2. How long does the recovery period after jaw surgery last?
The recovery period depends on the type of surgery and the individual’s condition, but it usually takes between 6 and 8 weeks. During this time, the patient should eat a soft diet and avoid strenuous activities. Full recovery and return to normal activities may take several months.
3. Is maxillofacial surgery painful?
This surgery is performed under general anesthesia, so the patient does not feel any pain during the procedure. After surgery, some pain and swelling are normal, which can be controlled with prescribed medications.
4. Will there be a scar on the face after jaw surgery?
No, most surgical incisions are made inside the mouth, so there is no scar on the face. In special cases where an external incision is required, the surgeon uses techniques that minimize scarring.
