Mandibular Osteotomy

In movies, especially in the older movies of the black and white era, you commonly see that one character with huge teeth that stick out, or a funny shaped brace on his teeth, for comic relief. While that may be funny on actors who are clearly faking a huge overbite (or under bite, whatever the role asks for), it is most definitely not a fun thing in real life. People who have jaw misalignment suffer from serious physical and psychological health issues as a result of the problem. Because of the clearly visible nature of the misalignment, located on the face, jaw disorders are critical for health and self-esteem.

When a person has a significant difference in the alignment of the upper and lower jaws, it causes ‘malocclusion’ or improper and incomplete closure of the jaws. In addition, once the baby or milk teeth have fallen out, the permanent teeth that replace them may be permanently restructured in keeping with the alignment of the upper and lower jaws. This leads to lifelong problems with closing the mouth, such as problems in speaking clearly, difficulty in eating normally, and obvious cosmetic issues. Growing through the teen years and early adulthood with jaw misalignment can have a serious negative impact on a person’s personality and social life. This is why people who have such significant jaw disproportion are advised to undergo a surgery called a Mandilbular Osteotomy.

A mandibular osteotomy is a simple procedure in which the oral surgeon or maxillofacial surgeon will essentially reposition the lower jaw, so that it fits better with the upper jaw and skull. The operation itself is not serious or painful, but is done under general anesthesia because of the area being operated and the necessary immobilization. Once you have been made comfortable, a small incision is made in your gums towards the back of your mouth, near your molar teeth. This lets your dentist get to the jawbone without hitting any major nerves or vessels. After exposing the jaw bone (which means moving all the superficial layers away from the incised portion), your surgeon will then use a saw-like ridged or toothed instrument to gradually saw through the bone downwards and obliquely, going very slow so as to not extend the break anywhere except the major line that has just been created.

This prevents damage to surrounding areas of the mouth and the teeth close to the molars. Then, based on the original plan of surgery that has been constructed by models before the surgery, your surgeon will insert a plastic wedge like piece to keep the two sawed ends in place while he fixes them more securely. Fixation of the two sawed parts in the predetermined position is done by using titanium plates and small threaded screws which provide a good, stable grip on the plates. Titanium is preferred for its nature, strength, resistance and nonreactive quality- it does not provoke immune reactions or get affected by the body atmosphere. Now the two parts of the jaw have been repositioned, and the layers over them are closed over the wound.

The operation for mandibular osteotomy is not painful, per se, but there is a margin of discomfort associated with it because the patient will have to cope with not being able to move his jaws and close his mouth initially, even though elastic bands help increase the motility right after the surgery. The surrounding area is likely to swell and be very tender for up to 7-10 days after the surgery. Your dental surgeon will prescribe painkillers for this, and cold compresses help reduce swelling. Sleeping upright for a first few days will reduce swelling and minimize chances of infection. Infections are a critical concern in the recovery period. Patients can return home in 1-2 days after the surgery, but proper and impeccable hygiene must be maintained at the wound site. Post operatively antibiotics are given, but it is better to avoid exposing yourself unnecessarily to infection, to promote rapid and complete healing after a mandibular osteotomy.

If you are interested in Mandibular Osteotomy surgery in Costa Rica, please fill out the “Help me Find a Dentist” form. A participating dental specialist will reply to your needs.