Arizona Jaw Surgery

03/09/2025

Why we do what we do. Thank you for the kind review!

11/15/2024

This patient had bilateral TMJ osteoarthritis, skeletal malocclusion, facial asymmetry, pain, and obstructive sleep apnea. All of her diagnoses were addressed with bilateral TMJ total joint replacement and segmental Lefort I osteotomy which allowed advancement of her jaws to open her airway.

04/25/2024

Nerve Repair! This patient suffered a nerve injury that required repair via nerve allograft.

First, we pre-bent a fixation plate to allow us to place the plate prior to making cuts to open the mandible and access the nerve. By doing so, when we apply the fixation plate at the end of the procedure, we know we are placing the patient back into their original position.

The nerve was located and inspected with significant damage along most of the nerve which required resection and then grafting of the nerve to the mental nerve which goes out into the lip and chin to provide sensation to this area.

The fixation was then re-applied and the procedure was completed.

Recovery of sensation will take several months or more for this patient.

04/02/2024

Check out our YouTube Channel. In this video, we provide an overview of Idiopathic Condylar Resorption including diagnosis, treatment options, and other factors patients should be aware of when dealing with this condition.

02/29/2024

This patient had bilateral painful TMJs with osteoarthritis that was unable to be improved with non-surgical measures. The patient was given treatment options and ultimately chose to proceed with bilateral TMJ meniscectomies (Disk Removal) with abdominal fat grafting.

The images show how minimal and hidden the incision sites are as well as the tissue planes involved to prevent facial nerve injury and other complications.

The abdominal incision is a 1cm vertical incision WITHIN the belly button so it will heal and be invisible without pulling on the belly button.

The TMJ incisions are hidden behind the ear cartilage on the lower aspect and then within a natural skin crease in the upper part to make the scar essentially invisible.

The video shows the lateral TMJ capsule while we move the mandible which causes the movement of the TMJ you see.

02/23/2024

This very nice young lady had a mandible (lower jaw) that was smaller than her upper jaw (maxilla). This led to issues with chewing and less than ideal esthetics. We treated her with Bilateral Sagittal Split Osteotomy (BSSO) of her mandible to correct his problem and improve her esthetics. Combining surgical treatment with orthodontic treatment led to an outcome that everyone (especially the patient) were happy with.

02/06/2024

This very nice but unfortunate gentleman developed severe trismus (limited mouth opening) to only 8mm of mouth opening following lengthy dental procedures. After attempts at non-surgical measures were unsuccessful and minimally invasive surgery (arthroscopy) helped only minimally, he was taken to the operating room for further treatment. We proceeded with a stepwise approach to limit his risk and morbidity. This started with removal of his left coronoid process (pictured) which resulted in opening to about 20mm. We then proceeded to right coronoidectomy which gained us a few more millimeters. We then removed his left TMJ disk (pictured) with abdominal fat grafting. This resulted in about 27mm of opening. Stretching while under GA resulted in improvement to an opening of 40mm (pictured). The patient will now proceed with aggressive physical therapy to improve and maintain his mouth opening and function.

01/09/2024

Revision Jaw (Orthognathic) Surgery

As one of only a handful of practices in the United States solely dedicated to jaw surgery, Dr. Wasson sees numerous revision jaw surgery cases each year. The need for revision jaw surgery can be due to several factors including but not limited to:

1. Complications from the previous surgery including

Poor healing resulting in the jaws being unstable (non-union, mal-union, or fibrous union)
Nerve injury that may require repair
Issues with fixation hardware (plates and screws used to secure the jaws to their new position) including loosening, infection, or irritation.

2. Unsatisfactory esthetic results

Some negative esthetic results are unable to be completely resolved due to numerous factors including surgical technique and the patient’s existing facial features and biology. However, if the esthetic outcome of orthognathic surgery was not discussed prior to the surgery so expectations where realistic or the outcome is different than intended, revision jaw surgery may be warranted.

3. Relapse or poor occlusal stability

Numerous factors can contribute to relapse or poor occlusal stability. Development of TMJ issues, continued growth, surgically halted growth, poor healing, inadequate orthodontic retention, osteoarthritis, and several other issues can result in an initially satisfactory result becoming an unsatisfactory one.

4. Development or exacerbation of TMJ issues

TMJ (Temporomandibular Joint) conditions can occasionally lead to issues with orthognathic surgery. Patients with existing TMJ disorders where the TMJ disorder is not addressed/treated prior to or at the same time as orthognathic surgery may develop worsening of their TMJ condition that leads to a need for revision jaw surgery and/or TMJ Surgery.

Although possible, patients with no history of TMJ disease tend not to develop them after orthognathic surgery. In the instance this does occur, if the TMJ condition is able to be treated and controlled then often no further intervention is required. If the TMJ disorder is persistent or leads to degenerative TMJ conditions such as osteoarthritis or Idiopathic Condylar Resorption, then TMJ surgery and/or revision jaw surgery may be needed.

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Jaw Surgery is performed by Scottsdale AZ Oral Surgeon when jaws don’t meet correctly or teeth don’t fit within the jaw.

12/07/2023

This patient has a large benign cystic tumor (Odontogenic Keratocyst) of the right mandible. Removal at this stage is challenging as it may result in mandible fracture and/or injury to the Inferior Alveolar Nerve which could result in permanent numbness for the patient. Due to these considerations, we elected to decompress the lesion with a drain (see photos) which will shrink the lesion over time (many months). Once the lesion is smaller, it is easier to remove with less chance of jaw fracture, nerve injury, and/or recurrence of the cyst.

11/15/2023

Planning TMJ total joint replacement is an involved but precise process. These images show the models and reports we receive after carefully planning the patient's surgery virtually. Exact measurements, screw lengths, models depicting the patient's anatomy, and images of the devices placed on a 3D rendering of the patient's skull and face help us plan and prepare for a precise and uneventful surgery where we know the result ahead of time.

11/08/2023

This unfortunate patient had severe trauma and repair that resulted in a severe malocclusion (bad bite) that prevented him from being able to bite/chew foods normally. This resulted in weight loss and a decrease in his quality of life. We were able to reconstruct his maxilla (upper jaw) with a Lefort I osteotomy and bone grafting that resulted in a drastically improved occlusion. He will complete orthodontic treatment which will further improve his condition and quality of life.