Growth of the jaws can be variable, sometimes causing an abnormal bite which, if significant, can cause difficulties eating or facial imbalance. This can be effectively treated with corrective jaw surgery in combination with orthodontic braces. Other jaw problems we commonly see include pain or locking around the jaw joint (TMJ dysfunction) and cysts or lesions that can grow within the jaw bones.
How we can help
Ben and James have a subspecialist interest in corrective jaw surgery (orthognathic surgery). Both surgeons completed overseas training fellowships in Orthognathic surgery and have considerable experience, interest and expertise in this area. Patients with jaw growth problems usually need a combined approach with an orthodontist to correct the alignment of the teeth with braces as part of the treatment before adjusting the jaw position surgically to achieve a perfect bite and facial proportion. Ben and James will often operate on Orthognathic patients together to give patients the very best considered approach. We use 3D virtual planning software to help deliver predictable outcomes for patients. See Jaw Surgery planning page
TMJ problems are frequently multifactorial and require a detailed assessment to reach the correct diagnosis and treatment must be tailored to the patient. Your surgeons are trained in diagnosing and treating a wide range of pathology, including cysts within the jaw.
About the procedure
Corrective jaw surgery is carried out under general anaesthetic and often requires an overnight stay in hospital after the procedure.
TMJ procedures range from botox injections into surrounding muscles to help ease pain, to intervention under general anaesthetic to improve the functioning of the jaw joint. A stepwise ladder of options is offered to try to improve symptoms in a minimally invasive way. Cysts or tumours of the jaw are often able to be surgically removed or biopsied under a short general anaesthetic. This is normally a day case procedure and temporary swelling is usually minimal.
Corrective Jaw Surgery (Orthognathic Surgery)
Sometimes as the facial bones develop, there can be disproportion between the upper and lower jaw resulting in a bite that is imbalanced. This can result in difficulty eating, unfavourable facial appearance, crowding or uneven wear of teeth. Sometimes braces alone are not sufficient to correct this and an adjustment of the position of one or both jaws is required to get the best function and appearance. Mr Gurney and Mr Sloane are experts in Orthognathic surgery and have both undertaken international fellowships in this area and work closely with orthodontic colleagues.
In order the harmonise facial balance, adjustment of the chin position may be required, either as part of orthognathic surgery when adjusting the bite, or as an isolated procedure for aesthetic reasons.
Obstructive Sleep Apnoea
Obstructive sleep apnoea (OSA) is a relatively common condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing. This can result in snoring, poor sleep and subsequent tiredness and health problems such as high blood pressure, stroke or diabetes. Lifestyle changes can help along with a machine at night to inflate the airways (CPAP). Oral and Maxillofacial surgeons help with this condition by constructing a mouth splint to help advance the jaw at night to keep the airways open or even adjust the jaw position with surgery to permanently improve the airflow and cure this condition.
Jaw Cysts & Tumours
Cysts and tumours can develop in either the upper or lower jaw. They can be identified on an X-ray incidentally or may present with symptoms such as swelling, pain, numbness of the lip or movement of teeth. Many of these lesions are benign, but some can be more destructive and require appropriate diagnosis and management, with consideration to the teeth and local anatomical structures. As jaw surgeons, Ben and James are well placed to advise on any requirements for advanced imaging techniques and biopsy as well as providing expert surgical treatment.
TMJ Joint Washout (Arthrocentesis)
Clicking or pain from a jaw joint is a common problem and often settles with simple jaw physiotherapy exercises and modifying eating habits. Occasionally the cartilage disc inside the jaw joint (TMJ) gets stuck and washing out the joint under a general anaesthetic can help reposition the disc and improve symptoms.
Placement of steroid within a TMJ joint either in clinic or at the time of a jaw washout (arthrocentesis) can help improve symptoms of pain in an inflamed jaw joint.
Botox Injection for Myofacial Pain
Muscles around the jaw joint such as the masseter or temporalis can become overactive due to increased tension, habits such as tooth grinding, or in response to a problematic jaw joint. This can result in pain or even enlargement of the muscle (hypertrophy). Injections of botox into the muscle can help relax the muscle without causing change to facial movement or symmetry and ease pain symptoms and normalise muscle size.
TMJ Disc Repositioning (Meniscopexy)
If the cartilage disc within the Temporomandibular joint is misaligned it can cause clicking, pain and reduced mouth opening. Sometimes if this is not responding to more conservative measures and if confimed on MRI scan, an open procedure under general anaesthetic can reposition this disc within the joint to improve symptoms and jaw function.