Jaw Surgery – Ege Aesthetic Dental Clinic Izmir Turkey

1.Lower Jaw Retraction

Advancement of the Lower Jaw Using the Genioplasty Method

In medical terms, lower jaw retraction is referred to as retrognathia inferior and can develop due to various reasons. Once a diagnosis is made by a specialist, a solution can be reached using orthodontic applications and surgical procedures.

While visual examination is useful in diagnosing lower jaw retraction, determining the underlying causes and severity of the condition is essential.

Although a diagnosis of lower jaw retraction may be based on visual findings, overdevelopment of the upper jaw may also contribute to the visual presentation.

To diagnose lower jaw retraction, necessary X-rays should first be taken, and a plaster model is often created. Following these procedures, an extraoral examination is conducted.

Once the degree of advancement or retraction is determined through thorough examinations, tests, and X-rays, the necessary steps for treatment are carried out by a specialist.

How Is Lower Jaw Retraction Treated?

Lower jaw retraction can occur for various reasons. Factors such as traumas during infancy or childhood, conditions occurring during birth, issues arising later in life, or genetic predispositions can contribute to the development of lower jaw retraction.

The causes of this condition need to be identified first. Understanding the root causes of lower jaw retraction is crucial for determining the appropriate intervention.

In the treatment of lower jaw retraction, after identifying the causes, it is important to understand the severity of the condition. The stage of the condition and the specifics of the issue are obtained through the specialist’s examination, tests, and X-rays.

After the necessary tests and examinations are performed by the specialist, intervention procedures are carried out. In the treatment of lower jaw retraction, both orthodontic treatments and surgical interventions may be necessary.

The procedures to be applied in the treatment depend on the underdevelopment of the lower jaw and may vary according to the overdevelopment of the upper jaw. The causes of the problem are also thoroughly examined, and appropriate interventions are chosen accordingly.

For individuals with severe lower jaw retraction, the issue does not only affect their appearance. Additionally, physiological problems may occur, including difficulties in chewing, breathing, and gum-related issues.

Failure to treat lower jaw retraction can lead to more significant problems over time. For this reason, it is essential to consult a specialist for timely treatment.

What Are the Symptoms of Lower Jaw Retraction?

The symptoms of lower jaw retraction are visually noticeable; however, the underlying causes cannot be determined solely through visual inspection.

The causes of lower jaw retraction are of great importance. It can be caused by genetic factors or trauma experienced during childhood.

The causes of lower jaw retraction may vary, and its symptoms are primarily aesthetic. Individuals with lower jaw retraction may also experience breathing difficulties.

Additionally, a deep palate may develop.

Lower jaw retraction symptoms, although primarily visual, can also lead to gum issues.

What Causes Lower Jaw Retraction?

The question of what causes lower jaw retraction can be answered by pointing to various factors, such as childhood trauma or genetic causes.

Lower jaw retraction can be linked to conditions like mandibulofacial dysostosis, Pierre Robin syndrome, otomandibular dysostosis, and micrognathia. Additionally, the use of forceps during childbirth can lead to lower jaw retraction.

Mandibulofacial Dysostosis
In some individuals, the condyles of the lower jaw are very small or absent, resulting in the absence of chewing muscles. These cases often present with a deep palate.

Otomandibular Dysostosis
After the lower jaw is positioned behind, developmental issues may occur in the jaw, with differences observed between the two sides of the face, leaving one side smaller than the other.

Pierre Robin Syndrome
This syndrome, which leads to lower jaw underdevelopment, may cause the tongue to fall back, along with a small lower jaw and cleft palate. In severe cases, it may result in breathing difficulties, which can be fatal. Immediate intervention is necessary with specialist support.

Micrognathia
Micrognathia is a condition where the jaw is both small and retracted. Difficult births involving the use of forceps can also lead to this condition, and genetic factors may play a role. Specialist intervention is needed for timely resolution.

Lower Jaw Retraction Surgery

Before surgery for lower jaw retraction, orthodontic treatment is applied to bring the teeth into the ideal position. During surgery, procedures are performed depending on the underdevelopment of the lower jaw or overdevelopment of the upper jaw.

In some cases, the use of wires, screws, or other appropriate devices may be necessary. All incisions are made inside the mouth, ensuring that there are no aesthetic concerns. After all the necessary procedures are completed, the surgery is finished. The use of braces before and after the surgery is often recommended to ensure successful treatment outcomes.

2.Lower Jaw Protrusion (Underbite)

Lower jaw protrusion, commonly referred to as underbite, is a condition where the lower teeth extend past the upper teeth, resulting in a misaligned bite. While it is not usually a severe medical issue, it can cause jaw pain, excessive wear on tooth enamel, and other uncomfortable side effects.

Aesthetically, many individuals may be dissatisfied with their appearance due to an underbite, as it can create a bulldog-like facial profile. In severe cases, the lower teeth may protrude significantly, while in milder cases, the misalignment may be subtle or barely noticeable. Simple cases may adapt to living with the condition, but more severe cases can lead to various oral health problems such as:

Difficulty eating, biting, and chewing
Challenges with speech
Facial and jaw pain due to misalignment

Causes of Lower Jaw Protrusion

Several factors can affect the alignment of your teeth. Typically, the upper teeth should slightly overlap the lower teeth, and the molars should fit together correctly to prevent biting your cheeks, lips, or tongue while eating.

There are several factors that can lead to the development of an underbite:

Childhood Habits
Certain habits developed during childhood can increase the risk of dental misalignment, including:

Thumb sucking
Pushing teeth with the tongue
Prolonged pacifier use in children over 3 years old
Extended bottle feeding beyond infancy

Genetics
Most often, an underbite is hereditary. If at least one person in your family has this condition, your chances of developing an underbite are higher. Genetics also determine the size and shape of a person’s jaw and teeth.

Injury
Serious facial injuries can cause permanent damage to the jawbones. While it is often possible to repair broken jawbones, post-surgical alignment may not always be perfect, leading to bite issues.

Tumors
Tumors in the jawbones or mouth can cause the jaw to protrude forward, leading to a misaligned bite.

Lower Jaw Protrusion Surgery

Most people are not born with perfectly aligned teeth. In many cases, mildly misaligned teeth do not require medical treatment. However, correction is beneficial, especially for severe cases, as it makes cleaning the teeth easier, reduces the risk of gum disease and tooth decay, and alleviates strain on the teeth, jaw, and facial muscles. This can also reduce the risk of tooth fractures and the painful symptoms associated with temporomandibular joint (TMJ) disorders, which are common in cases of underbite.

Treatment for Children
The earlier underbite is addressed, the better. If a child’s underbite is mild, they may need to wait until at least age 7 for corrective treatment, such as braces, when their permanent teeth have erupted.

In some cases, a facial mask device known as a reverse-pull headgear can help move the upper jaw and teeth into the correct position. Although it may seem intimidating, this is a common way to correct an underbite. The headgear rests on the forehead and chin, using elastic bands attached to braces or a retainer to gently pull the upper jaw into place.

Studies show that this method is up to 75% effective, especially if treatment begins before the age of 10. For the best results, the reverse-pull headgear should be worn as often as possible, ideally at night and even during the day. Using a reverse-pull facial mask can reduce the need for surgical correction later on.

In cases of severe underbite, particularly if it results from a birth defect such as a cleft lip, early surgery may help correct the condition. It is important to consult with a dentist to determine the best course of treatment. Surgery has its risks and should only be considered if the underbite interferes with the quality of life, eating, breathing, or speaking.

Lower Jaw Protrusion Surgery (Orthognathic Surgery)

Most oral and maxillofacial surgeons can successfully correct a protruding lower jaw. Various surgical techniques may be used, including reshaping the upper or lower jaw to achieve better alignment. In some cases, wires, plates, or screws may be used to maintain the shape of the jawbone. Surgery carries certain risks, including general anesthesia, infection, bleeding issues, and scarring.

Underbite surgery typically leaves no visible scars since all incisions are made inside the mouth. After surgery, the jaws may be wired or braced to ensure that the bones heal in the correct position.

Patients are generally advised to take 2-4 weeks off school or work following underbite surgery. Treatment often includes the use of braces before or after surgery.

Can Adults Be Treated for Lower Jaw Protrusion?

While appliances can be used in children to correct jaw position by applying pressure to the jaw and teeth during growth, adults with fully developed bones require orthognathic surgery for treatment. Orthognathic surgery is a procedure used when orthodontic treatment alone cannot correct facial, jaw, or dental deformities. These surgeries can help correct facial asymmetry. To correct lower jaw protrusion, the bone is cut, and the jaw is repositioned into its proper place.

Features of Jaw Surgery Applications

Jaw surgery operations are procedures targeting the jawbone and temporomandibular joint (TMJ). These surgeries are tailored according to the specific jawbone and joint problems our patients experience and aim to resolve these issues.

After identifying the patient’s jawbone and joint problems, treatment may involve surgery or orthodontic therapy. Initially, orthodontic treatment is applied to adjust the dental alignment, ensuring the teeth are correctly positioned before surgery.

Following jaw surgery, patients can typically resume normal functions such as eating, drinking, speaking, swallowing, and chewing without any issues. Depending on the operation, the jaw structure typically returns to normal within six months, and the effects of the surgery diminish.

Symptoms and Effects of Jaw Disorders

The symptoms of jaw joint disorders and complaints from our patients are listed below:

Facial asymmetry and disproportionality may develop.
Clicking or popping sounds are heard when opening and closing the jaw.
Limitations occur in the jaw’s movement in various directions (left, right, up, and down). In a healthy individual, the lower jaw moves about 2,000 times a day without any pain or issues.
Patients may experience difficulty and pain during chewing and biting.
Pain may occur around the jaw, joints, and mouth.
Dental misalignment due to jaw structure deformities may lead to orthodontic problems.
Patients may have difficulty opening their mouths, and pain can occur when opening and closing.
Jaw surgery issues may weaken patients’ ability to speak, making speech impairment one of the main indicators for jaw surgery.

Jaw Surgery Procedures

The following are the types of procedures performed in jaw surgery:

Surgical extraction of impacted or decayed wisdom teeth
Apical resection procedures
Cyst operations in jaw surgery
Periodontal surgery applications
Treatment for jaw dislocation
Surgical interventions for jaw fractures
Corrective surgery for jaw asymmetry
Surgical operations due to jaw trauma
Jaw prosthesis applications
Procedures for advancing or retracting the upper and lower jaw

Jaw surgery procedures are often performed in conjunction with orthodontic treatments. At the end of the operation, the patient’s jaw structure and dental alignment are normalized.

Wisdom Tooth Extraction in Jaw Surgery

For the extraction of wisdom teeth, it is necessary to follow the treatment plan outlined by our jaw surgery specialists. Issues related to wisdom teeth can develop due to environmental factors, chewing difficulties, nail-biting habits, or dietary and oral care practices.

Bacterial problems within the bone or gums can cause wisdom teeth to decay. Wisdom teeth are known to have the strongest roots within the dental alignment.

When a patient’s wisdom teeth are decayed or impacted, and fail to emerge, jaw surgery may be required for their extraction. The following are valid reasons for wisdom tooth extraction:

Poor hygiene around the wisdom tooth, making cleaning difficult
Cysts, lesions, or similar formations around the wisdom tooth, damaging the surrounding dental structure
Damage to neighboring teeth due to the wisdom tooth
Difficulty during chewing and speaking
Recurrent infections around the wisdom tooth

Types of Anesthesia Used in Jaw Surgery

Before starting jaw surgery, patients are administered general anesthesia. Depending on the techniques used and the duration of the procedure, patients may struggle to remain still during the operation.

To ensure that patients do not remember or experience any trauma during the procedure, general anesthesia is administered before the surgery begins. After the procedure, patients are typically observed for one day before being discharged. They usually return to normal activities within two weeks.

The general anesthesia and sedation methods used in jaw surgery ensure that patients undergo the operation painlessly and without trauma. After surgery, the pain threshold increases, minimizing any sensation of discomfort. For patients with dental anxiety or those undergoing lengthy procedures, our specialists may choose general anesthesia or sedation. These anesthesia applications are overseen by our anesthesiologists.