Mandibular Osteotomy: The operation is undertaken through an incision made at the back of the mouth in the gum by the molar teeth to gain access to the jaw. The lower jaw is then cut in an oblique fashion with a small saw to allow it to be broken in a controlled manner. It is then moved into its new position, which has been predetermined during surgical planning with the aid of models of your teeth. A small plastic wafer is attached to the teeth to allow the new position of the lower jaw to be determined, which is then fixed into place with small metal plates and screws. These are made of titanium that is a very inert metal and safe to be used in the body. The gum is stitched back into place with dissolvable stitches.
When you wake up from the operation you will have some small elastic bands between the upper and lower teeth. These are to help guide your teeth into their new position and therefore you will not be able to open your mouth fully.
If you have had mandibular segmental surgery (i.e if your bottom jaw has been sectioned further) then you will have a small plastic wafer attached to your lower teeth as well as elastic bands between your upper and lower jaw. In this case the wafer is usually removed a week following surgery, although in some cases can be longer. You will be advised if this is likely prior to surgery.
This is not a very painful operation and when you initially wake up you will feel the area around the jaws to be numb. However you will find your mouth and jaws feel generally uncomfortable in the first 2-3 weeks following surgery. Regular simple painkillers are usually needed initially and these will be given to you to take home from hospital.
Swelling usually gets worse up to 4 days following surgery and will then gradually start to settle. Using cold compresses can reduce this and sleeping propped upright for a few days. Most of the swelling has usually disappeared after a fortnight but there is often some subtle swelling that can take several months to disappear although only you and your family are likely to notice this.
It is also necessary to make sure that the area heals without any infection and so you will be given antibiotics whilst you are in hospital that will be continued for a few days when you return home. You will also be given an antibacterial mouthwash, this should be used twice daily, morning and night. Hot salt water rinses after meals will also help keep the wounds clean and reduce debris with the mouth.
It is likely that you will have a small amount of bleeding from the mouth for a few days following surgery. A sore throat and difficulty swallowing can also be expected.
There are potential complications with any operation. Fortunately with this type of surgery complications are rare and may not happen to you. However it is important that you are aware of them and have the opportunity to discuss them with your surgeon.
A review appointment will be arranged before you leave hospital to see both the surgeon and orthodontist usually a week following surgery. You will need to come back regularly during the initial healing phase to ensure that your bite is maintained in its new position and for adjustment of the elastic bands between your teeth.