Dr M P BRAVERMAN & Dr R P GREWAL - Certified Specialists in Oral and Maxillofacial Surgery  
  • Dental Implants
  • Wisdom Teeth
  • Extractions
  • Dentoalveolar Surgery
  • Pre-Prosthetic Surgery
  • Bone Grafting
  • Sinus Lift
  • Socket Grafting
  • Soft Tissue Grafting
  • Corrective Jaw Surgery
  • Facial Trauma
  • TMJ Disorders
  • Anesthesia
Corrective Jaw Surgery & Facial Trauma
What is Corrective Jaw Surgery?
Orthognathic Surgery, known as Corrective Jaw Surgery corrects minor and major dental and skeletal abnormalities. Corrective jaw surgery includes the correction of misaligned jaws and teeth, which will improve speaking, chewing, and breathing. The primary goal is to correct your functional problems, but this procedure can also dramatically enhance your appearance.
What Conditions May Require Corrective Jaw Surgery?
Chronic jaw joint or jaw pain and headaches
Open bite (a space between your upper and lower teeth when your mouth is closed)
Birth defects or facial injury
Unable to make lips touch without strain
Difficulty biting and chewing food
Difficulty swallowing
Sleep apnea (unable to breathe properly while sleeping, including snoring)
Facial appearance is unbalanced from the front or side
Chronic dry mouth and mouth breathing
Excessive teeth wear\
Protruding jaw
Receding chin
    Figure 1 (Left):  Lower jaw is protruding out causing an underbite.(Right):  The bone in the rear portion of the jaw is separated and the front is repositioned back.  
    Figure 2 (Left):  Upper jaw is protruding out causing an overbite.(Right):  The bone in the front portion of the jaw is separated and the front is repositioned forward.  
What Causes Jaw Misalignment?
Sometimes, the upper and lower jaws grow at different rates. Birth defects and injuries can also cause jaw misalignment. Orthodontics can usually correct bite problems when only your teeth are not aligned; however, corrective jaw surgery may be necessary to correct jaw misalignment.
How Do I Know if I Need Corrective Jaw Surgery?
A team approach involving your Oral Surgery Specialist, Dentist and Orthodontist will determine whether you need corrective jaw surgery. We will determine which procedure will correct your problem. Your treatment will likely include orthodontics before and after corrective jaw surgery, which can take several years to finish. Your Oral Surgeon, along with your Orthodontist and Dentist will determine the course of treatment that best suits your needs.
What is the Treatment Plan for Corrective Jaw Surgery?
Orthodontic Braces:
Prior to surgery, you will need to wear braces that will move your teeth into a new position. Since your bite is being prepared so your teeth fit together after surgery, you may think that your teeth don’t fit together properly and your mouth is getting worse. However, when your jaw is repositioned, your teeth should fit well together. Closer to surgery, we will take additional x-rays and models of your teeth to ensure that your teeth will be properly aligned during surgery.
Corrective Jaw Surgery:
This procedure can be performed under general anesthesia and can take anywhere from one to several hours to finish.
Your jaw will be repositioned to suit your specific needs. Bone may be added, reshaped, or taken away. You also may require screws, surgical plates, rubber bands and wires to secure your jaws in their new locations. Usually, incisions are made inside your mouth to reduce noticeable scarring. Some cases require some small incisions on the outside of the mouth. We will minimize the appearance if these incisions are necessary.
After Surgery:
You will be instructed to modify your diet, which could include liquids and solids, with a schedule for changing over to a normal diet. You should also avoid using tobacco products and engaging in strenuous physical activity.
Pain after your corrective jaw surgery can be easily managed with medication and you will be able to return to school or work between one and three weeks after surgery. Initial healing takes about six weeks, while total healing of the jaw takes approximately nine to twelve months.
What are the Benefits of Corrective Jaw Surgery?
By undergoing corrective jaw surgery, your teeth are repositioned in a more functional, balanced and healthy manner. Some patients experience drastic enhancements to their appearance and speech.
Facial Trauma:
Oral and Maxillofacial surgeons are highly trained and skilled to evaluate and treat facial trauma. Naturally, injuries to the face bear a lot of physical, as well as emotional, trauma and both surgeons are attuned to the sensitive nature of these types of injuries.
What are Types of Facial Trauma?
Knocked-out teeth
Fractured jaws (lower and upper jaw)
Fractured facial bones (eye socket, cheek, or nose)
Facial lacerations
Intra oral lacerations
What Causes Facial Trauma?
There are several causes of facial trauma, such as sports injuries, motor vehicle accidents, interpersonal violence, accidental falls, and work-related injuries. The types of facial injuries range from moderate to severe (as moderate as injuries to teeth, to extremely severe injuries to the skin and bones of the face). Facial injuries are categorized as soft tissue injuries (skin and gums), bone injuries (fractures), or extraordinary regions (such as facial nerves, eyes or the salivary glands).
How are Facial Injuries Treated?
Soft Tissue Injuries:
Soft tissue injuries are repaired by suturing with the goal to ensure the best cosmetic results and that your facial nerves, salivary glands, and salivary ducts are intact and functioning properly.
Bone Injuries:
Fractures to the bones in your face are treated similarly to fractures in other parts of your body. The form of treatment is dependent on the location and severity of the fracture, your age and general health. A cast is often used when an arm or leg is fractured, but since a cast cannot be placed on your face, we have other methods to stabilize facial fractures.
Sometimes jaws are wired together for fractures to the upper and/or lower jaw. Other types of jaw fractures are treated by surgically placing small plates and screws at the injury site. This technique is often favored because jaws do not need to be wired together and can still allow for necessary healing. This type of procedure allows patients to return to normal function quickly.
We ensure your appearance will be minimally affected by accessing facial bones using the fewest incisions necessary. All necessary incisions are small and place so the resultant scar is hidden.
  Figure1: Jaw Fracture   Figure 2 : Surgical Plates Placed at the Surgical Site   Figure 3 : Normal Function Quickly Returned  
Teeth and Surrounding Dental Structures Injuries
Oral surgeons commonly treat fractures in the supporting bone to the injured teeth, or replanting teeth that have been knocked out or displaced. These injuries are treated by a number of forms of splinting (bonding or wiring teeth together). If your tooth is knocked out, it should be placed in salt water or milk to keep it healthy. The tooth needs to be inserted back into the dental socket as soon as possible for the best chance of survival. You should never wipe the tooth off because there may be remnants of the ligament that held the tooth in the jaw and are vital to replanting the tooth successfully.
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