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Maxillary Osteotomy

This procedure is planned when it is not possible to correct the teeth and how they bite together with orthodontics alone. This is because the bones of the face and jaws are out of balance with each other. Surgery will change the relationship between the lower jaw and upper jaw and will correct these problems. The surgery will take place under a general anaesthetic, ie the patient is going to be put to sleep completely.

The operation is almost entirely carried out from the inside of the mouth to minimise visible scars on the skin of the face. A cut is made through the gum behind the back teeth to gain access to the jawbone. The upper jaw is then cut with a small saw to allow it to be separated in a controlled manner. It is then moved into its new position and held in place with small metal plates and screws.

The gum inside the mouth is stitched back into place with dissolvable stitches that can take a fortnight or even longer to fall out.

The procedure takes place in a hospital. The discomfort is usually worse for the first few days although it may take a couple of weeks to completely disappear regular pain reliefs will be arranged. Patients are sent home with pain relief and a course of antibiotics.

Immediately after the operation the face will be swollen, feel tight and jaws will feel stiff. Patients find that they cannot open their mouth widely. The throat may also be uncomfortable and swallowing can be difficult initially.

Swelling and bruising is variable but is generally worst on the second or third day after the operation. The swelling can be reduced by using cold compresses and sleeping propped upright for a few days. Most of the swelling has disappeared after a fortnight but there is often some subtle swelling that can take several months to disappear.

Initially, for the first day or two patients will only want liquids, but very quickly they should be able to manage a soft foods and then gradually build up to normal diet over next few weeks.

This varies from person to person but most patients spend two or sometimes three nights in hospital after this operation. The position of the jaw will be checked with X-rays.

Most people have around a week or two off work. Make sure that this is arranged prior to the operation.

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