Name of the Procedure:

Osteotomy, Mandible, Segmental

Summary

A mandible segmental osteotomy is a surgical procedure where a portion of the lower jawbone (mandible) is cut and repositioned to correct abnormalities. This procedure can help improve functionality, aesthetics, and overall oral health.

Purpose

• Condition: This procedure addresses conditions such as mandibular deformities, malocclusion (misalignment of teeth), or facial asymmetry.
• Goals: The goal is to improve chewing, speaking, and aesthetic appearance, leading to enhanced quality of life.

Indications

• Misaligned bite (overbite, underbite)
• Jaw growth abnormalities
• Severe facial asymmetry
• Obstructive sleep apnea
• Temporomandibular joint (TMJ) disorders

Preparation

• Instructions: Patients may need to fast for 8-12 hours before surgery.
• Medications: Adjustments to current medications, especially blood thinners.
• Assessments: Preoperative assessments including dental x-rays, CT scans, and possibly an orthodontic evaluation.

Procedure Description

1. Anesthesia: Administered general anesthesia.
2. Incisions: Small incisions are made inside the mouth to access the mandible.
3. Cutting the Bone: Segments of the mandible are cut using specialized surgical tools.
4. Repositioning: The jaw segments are realigned to their desired position.
5. Fixation: Miniature screws, plates, or wires are used to stabilize the realigned bone segments.
6. Suturing: Incisions are sutured closed, often with dissolvable stitches.

Duration

The procedure typically takes about 1-3 hours, depending on the complexity.

Setting

Performed in a hospital or surgical center with the necessary facilities for general anesthesia and postoperative care.

Personnel

• Oral and maxillofacial surgeon
• Surgical nurse
• Anesthesiologist

Risks and Complications

• Common: Swelling, bruising, pain, numbness
• Rare: Infection, excessive bleeding, injury to adjacent structures, unfavorable scarring, non-union of bone segments, relapse of jaw position

Benefits

• Improved jaw function
• Enhanced facial symmetry
• Better alignment of teeth
• Relief from pain or discomfort associated with jaw abnormalities
• Benefits often realized within a few weeks to several months post-surgery

Recovery

• Care: Prescribed pain management medications and possibly antibiotics.
• Instructions: Soft or liquid diet, strict oral hygiene, avoiding strenuous activities.
• Recovery Time: Most patients return to normal activities within 2-4 weeks, with full recovery taking several months.
• Follow-up: Routine follow-up appointments for monitoring healing and any orthodontic adjustments.

Alternatives

• Orthodontic Treatment: May correct minor issues without surgery but less effective for severe cases.
• Non-Surgical Therapies: Physical therapy for TMJ disorders, dental appliances for sleep apnea.

Patient Experience

• During Procedure: Under general anesthesia; no sensation or awareness of the procedure.
• Post-Procedure: Expect some pain, swelling, and temporary numbness in the affected area. Pain is managed with prescribed medications, and comfort is enhanced with cold compresses and a soft diet.