Maxillofacial Surgery and Maxillary Osteotomy: Principle and Follow-up
This maxillofacial surgery (also called maxillary osteotomy) makes it possible to regain good positioning of the upper jaw. The intervention may be required in different configurations. It follows a precise procedure and requires the respect of several precautions, before as well as after the operation. Here is a complete overview of its usefulness and of the procedure to follow for patients.
The principle of the operation
Jaw surgery is performed in order to reposition bone segments and to perfectly re-establish the upper jaw in its normal position. It is indicated in people who suffer from a dental occlusion abnormality. When the jaw is poorly placed, the teeth do not fit together correctly and many problems can appear. We can notably cite an anterior open bite, very visible gums or a retromaxillism.
These disorders generate both aesthetic discomfort in patients and difficulties on a daily basis, such as embarrassment when speaking or eating, clicking and contractures of the jaw, pain or a risk of tooth loosening. It is therefore necessary to resort to the operation as soon as possible, most often in addition to an orthodontic treatment. Depending on the situation, other interventions may be necessary, notably at the level of the chin.
Precautions and course of the operation
This common surgical intervention is safe for the patient. Before the operation, consultations are organised with a surgeon to examine the state of the jaw and define the course of the intervention. It is mandatory not to smoke, not to consume alcohol, not to eat spicy food and not to take aspirin in the 10 days preceding the operation. This rule must be respected thereafter until healing. On the day of the operation, the patient must moreover remain fasting from midnight.
In the case of a maxillary osteotomy, a hospitalisation of 1 to 3 days is the norm. Under general anaesthesia, the intervention lasts between 1 and 3 hours. During this time, incisions are made in the oral mucosa (they will remain invisible from the outside). The maxilla is then cut above the teeth in order to be moved to the desired area. Guided by computer, the operation is carried out using custom-made splints. The bone fragments are fixed with screws and mini-plates in titanium, then the incision is closed with absorbable sutures.
The next day, elastic bands are installed to accompany the jaws following this movement.
Follow-up and results
After the intervention, an oedema at the level of the cheeks and lips may appear, on which ice packs will need to be applied. Slight nosebleeds are possible during the first days. In case of pain, the taking of painkillers is recommended.
During the first phase, a limited opening of the mouth will be the norm. Soft or blended foods will be favoured during meals. After about ten days, a postoperative consultation will be scheduled. To avoid possible complications, medical follow-up will extend over several months.
The operation may give rise to a sick leave of between 2 and 5 weeks. Good dental and dietary hygiene is to be observed, with the use of mouthwashes. A rehabilitation of the joints may be put in place to quickly recover the mobility of the jaw.
