In surgical procedures applied to correct skeletal incompatibilities in the mouth and jaw area, an individual’s biological age and stage of bone development are among the most critical medical parameters. Whether the jawbones have completed their growth potential directly affects the timing of the intervention and the permanence of the functional gains that will be achieved. In medical processes carried out in the Istanbul region, Opc Klinik — serving in particular the Kadıköy and Suadiye locations — carefully monitors individuals’ developmental stages to create personalized plans. This comprehensive content provides detailed information on why age is a decisive factor in orthognathic surgery processes, how bone development is medically analyzed, and the diagnostic steps that should be applied within the framework of 2026 health regulations.

Why Is Age the Most Critical Criterion in Planning Orthognathic Surgery (Jaw Surgery)?

In the human body, the lower and upper jawbones, just like the arm and leg bones, tend to elongate and expand in volume up to a certain age. Orthognathic surgery is a procedure that surgically cuts the existing bone (osteotomy) and moves it to a new, ideal position. If this anatomical repositioning is carried out before the bones’ growth spurt has ended, the body’s physiological growth dynamics will disrupt the balance achieved through treatment. For this reason, healthcare institutions in Istanbul focus, before the surgical operation, not just on the patient’s calendar age but on their skeletal bone age.

Within What Age Ranges Does Skeletal Jaw Development Get Completed?

Growth curves vary in each individual according to genetic factors, eating habits, and hormonal balance. Since the pubertal growth spurt begins at an earlier age in girls, skeletal maturation is completed earlier compared to boys. The generally accepted anatomical development stages when planning jaw surgery are as follows:

What Are the Medical Drawbacks of Performing Jaw Surgery While Growth Is Still Ongoing?

Surgical interventions performed at an early age can leave the individual facing the need for a second operation in later years. For example, in a young patient with a lower jaw that is growing more than normal (prognathism), if the lower jaw is brought back before growth has stopped, it will project forward again with the pubertal growth spurt. This is not only an aesthetic or structural loss but also a medical complication that can lead to irreversible damage to the jaw joint (temporomandibular joint). Avoiding such risks forms the basis of international surgical principles.

How Is Developmental-Stage Monitoring Carried Out at Istanbul Opc Klinik?

Deciding that growth has stopped is not a process determined solely by looking at the patient’s date of birth. Within the interdisciplinary approach at the Suadiye and Kadıköy branches, orthodontics specialists and jaw surgeons analyze clinical data together. Lateral cephalometric X-rays taken are overlaid with the previous year’s X-rays using special medical software. If any elongation, even at the millimeter level, is observed at the chin tip or upper jaw points, it is understood that growth is continuing, and the surgical process is put on hold. At the same time, the cessation of height growth also provides physicians with secondary clinical evidence that bone development has concluded.

How Do Differences Between Skeletal Age and Biological Age Affect Orthognathic Surgery?

One of the aspects physicians pay the most attention to in medical diagnostic processes is precisely these developmental differences. Hormonal makeup, illnesses experienced in childhood, or genetic predispositions can slow down or speed up bone development. For this reason, reaching legal age (turning 18) alone is not considered a sufficient criterion for orthognathic surgery. One of the most valid methods used in determining bone age is examining the fusion rates (calcification stages) of the small bones in the hand and wrist relative to each other.

Can Jaw Growth Be Guided with Orthodontic Treatment During the Developmental Period?

Although orthognathic surgery is a definitive solution for bone incompatibilities, correct orthodontic interventions applied at an early age can spare some patients from needing surgery. In this treatment approach, called growth modification, an attempt is made to achieve skeletal balance while the bones are still soft and can be guided. However, once the growth spurt has ended (once the bones have hardened), the ability of functional appliances to change bone size disappears. From this stage onward, the only medical solution for detected skeletal incompatibilities is orthognathic surgery (jaw surgery) procedures.

Can Jaw Surgery (Orthognathic Surgery) Be Planned for Older Individuals?

The main motivation of patients who have jaw surgery in adulthood or middle age is to resolve the functional problems (jaw joint pain, tooth wear, breathing problems) that have accumulated over the years due to an incorrect bite. In older age, the rate of bone renewal (metabolism) may proceed more slowly compared to younger individuals, so post-operative tissue healing and the full fusion of the bones is planned to take a few weeks longer. Before the operation, under Opc Klinik’s procedures, the patient’s chronic conditions (hypertension, diabetes, etc.) are examined in detail and a consultation with the anesthesiologist is carried out.

How Does Jawbone Quality (Osteoporosis Status) in Adults Change the Surgical Process?

Decreases in bone mass do not mean surgery cannot be performed; however, they do change the osteotomy (bone-cutting) method and the fixation protocol the surgeon will use. If the cortical (outer) layer of the jawbone is not sufficiently firm, in order not to risk the fusion of the bones during the healing period, the patient’s teeth may be kept bound together with special elastics for a longer period after the operation, or the liquid-diet period may be extended. Such detailed planning is optimized according to the individual’s anatomical reality in Istanbul-based clinical processes.

Which Radiological Tests Are Requested Before Jaw Surgery (Orthognathic Surgery)?

With the advancement of medical technology, orthognathic surgery preparations have evolved from two-dimensional planning to three-dimensional digital simulations. The table below details the functions of the requested tests in operation planning:

Why Is a Multidisciplinary Approach Mandatory at Opc Klinik’s Kadıköy Branches?

This requirement stems from the fact that the treatment rests on two main pillars. The orthodontist (braces specialist) prepares the jaws for surgery an average of 1-1.5 years before the operation by bringing the patient’s teeth into their correct angles within the bone (decompensation). The jaw surgeon then cuts the bone, whose teeth are now ready, and moves it to its new anatomical location. If instant, digital communication between these two specialists is not established, it becomes impossible for the teeth to fit together fully and precisely (occlusion) during the operation. The treatment protocols carried out at the relevant locations allow physicians to perform joint virtual surgical planning over the same digital database.

Are There Exceptional Medical Situations Requiring Surgery Before Jaw Development Is Complete?

In such extreme cases, the purpose of the operation is not to achieve aesthetic balance but to secure the patient’s physiological survival functions (breathing, nutrition). In mandatory jaw operations performed at an early stage, physicians, knowing the individual will continue to grow, inform the family and the patient in detail that a secondary corrective operation (revision surgery) will be needed at a later age. However, early surgery is always avoided in standard skeletal bite disorders that do not pose a life-threatening risk.

In What Ways Do Skeletal Jaw Disorders Affect an Individual’s Life Functions?

The perception that jaw surgery is merely an aesthetic procedure that changes profile appearance is incomplete. Skeletal disorders lead to chronic functional damage that directly strains the human metabolism. Teeth not making contact in an ideal position causes continuous asymmetric loading of the temporomandibular joint (TMJ) area and, over the years, the degeneration of the joint discs. Food swallowed without proper chewing can disrupt the balance of stomach acid, creating conditions for digestive issues such as reflux. Orthognathic surgery is an entirely health-focused surgical intervention that resolves this entire domino effect at its source by correcting the anatomical alignment of the jawbones.

Orthognathic surgery, applied to resolve skeletal jaw disorders, is a medical procedure that brings the lower and upper jaws into their ideal functional positions. Which individuals are biologically suited to this treatment is determined by taking a holistic approach to medical factors such as anatomical development, chewing dynamics, and airway capacity.

Who Is Orthognathic Surgery (Jaw Surgery) Suitable For?

Orthognathic surgery (jaw surgery) is a suitable medical procedure for individuals experiencing skeletal incompatibility due to growth differences between the lower and upper jawbones, resulting in noticeable impairments in chewing, breathing, and speech functions. Individuals with severe bite disorders that cannot be corrected through orthodontic treatment (braces) alone are among the primary candidates for this surgery.

A common feature of these individuals is that the problem stems not only from the alignment of the teeth but directly from the volume, position, or angle of the jawbones that carry the teeth. The disproportion between the jawbones creates conditions for an inability to properly grind food, and consequently digestive system problems. In the radiological diagnostic processes of clinics operating in the Istanbul region, these major deviations in bone structure are measured down to the millimeter, the functional benefit the operation will provide to the patient is calculated, and the individual’s suitability for surgery is based on this objective data.

What Symptoms Indicate Skeletal Jaw Disorders?

Skeletal jaw disorders present with physical symptoms such as the front teeth not touching each other, the lower jaw being positioned further forward or backward than normal, facial asymmetry, and difficulty biting and grinding food. In addition, chronic mouth breathing and clicking sounds coming from the temporomandibular (jaw) joints are among the most noticeable physiological signs of skeletal incompatibility.

Symptoms can reach a level that disrupts an individual’s daily life functions. When the jawbones do not fit together at the correct angles during closure, the load on the muscles and joints is distributed unevenly. The findings observed in identifying skeletal disorders include the following:

• The lips not touching each other at rest (without contraction), requiring the lip muscles to strain in order to close the mouth.
• A lisp or difficulty pronouncing certain sounds (such as s, z, p, b) during speech.
• Excessive vertical growth of the upper jaw resulting in too much gum showing during smiling (gummy smile).
• Noticeable differences (asymmetry) between the right and left halves of the face in the chin tip or overall jawline.

Why Is Orthodontic Treatment (Braces) Alone Insufficient?

Orthodontic treatment alone is insufficient because braces and clear aligners can only change the inclination and alignment of the teeth within the bone; they cannot move the volume, length, or skeletal position of the jawbones that carry the teeth. Since the bone incompatibilities underlying skeletal disorders cannot be resolved by correcting the teeth, surgical intervention becomes a medical necessity.

In individuals in the growth and development years (generally before ages 12-14), since the bone structure still retains some flexibility, the growth of the jawbones can be guided to some extent with special appliances. However, once the growth spurt ends, the bones take their final shape and harden. If, in an adult, the lower jawbone is far forward relative to the upper jaw, the orthodontist may try to achieve a “camouflage” simply by tilting the teeth backward; however, this is not always possible or healthy for the roots of the teeth. Anatomically repositioning the bone can only be achieved by surgically cutting it (osteotomy) and re-fixing it in the correct position with plates and screws.

What Medical Criteria Are Assessed When Deciding on Jaw Surgery?

When deciding on jaw surgery, medical criteria such as whether the patient’s bone development has fully finished, the radiological width of the airway, the condition of the jaw joint, and the bite relationship between the upper and lower teeth are assessed. Physicians approve this treatment after a detailed examination of the individual’s anatomical structure using three-dimensional tomography and cephalometric analyses.

The key medical factors determining suitability for the operation are detailed below:

Is Orthognathic Surgery Suitable for People with Sleep Apnea and Breathing Problems?

Orthognathic surgery is a functional treatment option for individuals experiencing sleep apnea and breathing problems, particularly those with a jaw positioned further back. Surgically bringing the jawbones forward also moves the tongue base and soft tissues narrowing the airway forward, widening the airway passage and easing oxygen flow during sleep.

Obstructive sleep apnea is when breathing stops for certain periods during sleep. This condition often results from a small, recessed lower jaw causing the tongue to block the airway when lying on the back. In patients who cannot use methods such as CPAP (a breathing device) or who have significant narrowing detected in their skeletal anatomy, the procedure of advancing both jaws together (bimaxillary advancement) can be applied. Medical research shows that this skeletal movement physiologically widens the airway volume, improving breathing quality and largely eliminating snoring complaints.

How Are Individuals Experiencing Loss of Chewing and Speech Functions Assessed?

Individuals experiencing loss of chewing and speech functions are examined through an intraoral clinical exam, joint movement tests, and phonetic assessments to identify deficiencies at the contact points of the teeth. Since patients whose teeth do not fully close cannot grind food and cannot correctly pronounce certain letters, a surgical process is planned.

Digestion begins in the mouth. When the upper and lower teeth cannot achieve grinding contact with each other (open bite or asymmetry), food is swallowed without being sufficiently broken down, placing extra load on the stomach and intestinal system. At the same time, patients whose front teeth do not touch cannot perform the tearing action. From a speech perspective, the tongue’s inability to touch the correct articulation points leads to pronunciation disorders. In Opc Klinik’s processes, when such functional losses are identified, a treatment map is created to bring the patient’s skeletal structure into the ideal position.

How Is Planning Carried Out by Opc Klinik at Its Istanbul Kadıköy Locations?

The planning process carried out by Opc Klinik in the Kadıköy area is conducted by using digital intraoral scanners and three-dimensional tomography scans to precisely transfer the patient’s existing skeletal structure into a computer environment. Following a joint consultation between the orthodontist and the jaw surgeon, virtual surgical planning is performed, and the new positions of the bones are medically clarified before the operation.

The pre-surgical preparation stage requires extremely meticulous medical procedures. Digital records obtained with intraoral scanners, instead of traditional impression materials, are matched with the patient’s tomography. This integration allows physicians to move the jawbones within a virtual simulation. The exact millimeter at which the bone will be cut (the osteotomy line) and the “surgical guide splints,” which ensure the jaw is brought into the correct position during the operation, are produced using 3D printers thanks to this software. This multidisciplinary approach at the Suadiye and Kadıköy branches is a standard medical working model that increases the success of the operation and identifies and prevents possible risks before the surgery.

What Are the Age Limit and Developmental Criteria for Orthognathic Surgery?

The age limit for orthognathic surgery, since it is based on the individual having fully completed their skeletal growth and development, is generally around age 18 in women and around ages 20-21 in men. Performing the operation on patients who have not completed their development is not considered medically appropriate, as it carries the risk of the jawbones continuing to grow according to their own genetics.

Interventions performed during the growth period can cause skeletal incompatibility to recur at a later age. Whether a patient’s growth potential has stopped is determined by radiologically monitoring the closure status of the growth plates (epiphyseal cartilage) in the wrist bones. As for the upper age limit, there is no strict rule. Patients in older age groups can be included in the surgical process if found suitable, based on an assessment of their bone density, cellular healing capacity, and any chronic disease profile that could prevent them from undergoing anesthesia.

Can Individuals with Systemic Health Problems Have Jaw Surgery?

Individuals with systemic health problems can have jaw surgery, provided they do not have conditions that would prevent general anesthesia, such as severe heart disease, advanced lung disease, or uncontrolled diabetes. Medical suitability is finalized through comprehensive blood tests, an anesthesia examination, and approvals from the relevant specialist physicians conducted before the operation.

Since orthognathic surgery procedures are performed under general anesthesia in a hospital setting, the patient’s overall body functions must be stable. The effects of systemic chronic conditions are managed in operation planning as follows:

• Diabetes: Diabetic patients whose HbA1c value is kept within the reference range and who are under regular monitoring can be accepted for the operation. However, if blood sugar levels are erratic, the operation is postponed, since tissue healing would be put at risk.
• Bleeding Disorders and Medication Use: The doses of blood-thinning medications used by patients are adjusted, under the supervision of the relevant physician (cardiologist or internist), a certain period before surgery, in order to manage bleeding risk.
• Bone Metabolism Disorders: In patients with advanced bone loss (osteoporosis), since the capacity of titanium plates and screws to be fixed to the bone may be weak, detailed bone density analyses are requested.

Who Is Required to Undergo Pre- and Post-Operative Orthodontic Treatment?

Pre- and post-operative orthodontic treatment is mandatory for every patient planned for orthognathic surgery, so that the teeth can fit together anatomically after the bone movements. Before surgery, the teeth are brought into their ideal angles on the jawbone; after surgery, the goal is to fully stabilize the chewing balance in the new skeletal position.

Over the years, the teeth of individuals living with a jaw disorder tilt in various directions to adapt to (compensate for) the existing faulty bite. During the pre-operative preparation (decompensation) stage, these incorrect inclinations are corrected by fitting orthodontic braces, bringing the teeth into the correct upright angles relative to the bone base they belong to. During this stage, the patient’s externally visible jaw disorder may become more pronounced for a temporary period; this is an expected part of the medical planning. In the post-surgical orthodontic period, the contact (occlusion) between the upper and lower teeth in the repositioned jaws is refined down to the millimeter, fully establishing the physiological limits of chewing function.

Today, skeletal differences in the mouth, teeth, and jaw structure can directly affect an individual’s chewing, speech, and breathing functions. Orthognathic surgery procedures carried out at healthcare institutions in the Istanbul region center on anatomically correcting these functional disorders. Carried out at Opc Klinik, these medical procedures, applied to regulate the relationship between the teeth and the jawbones, require a comprehensive assessment and planning process.

What Is Istanbul Orthognathic Surgery (Jaw Surgery) and What Physiological Purposes Does It Serve?

Istanbul orthognathic surgery is a comprehensive surgical intervention that brings the teeth and jaws into their ideal functional positions in order to correct growth differences between the lower and upper jawbones, skeletal asymmetries, and bite disorders. Its main purpose is to make the act of chewing — the first step of digestion — healthy, to ease the airway, and to eliminate the uneven load distribution on the jaw joint.

Disproportionate growth of the jawbones during the developmental years, genetic factors, or trauma experienced later in life can disrupt the harmony between the lower and upper jaw. In such skeletal-origin cases, which cannot be corrected with orthodontic (braces) treatment alone, surgical intervention becomes a medical necessity. The operation is not just a structural correction procedure; it also aims to prevent long-term tooth wear and gum problems. The surgical process is based on the principle of repositioning the bones and having this new position heal by integrating with the body’s tissues.

How Do Bite Disorders Affect Individuals’ Daily Life Functions?

Bite disorders restrict an individual’s ability to tear and grind food, leading to digestive system problems; prevent certain sounds from being pronounced correctly, causing speech disorders; and narrow the airway during sleep, triggering serious respiratory problems such as sleep apnea.

Bite disorders (malocclusion) refer to a deviation of the teeth from their ideal alignment. When stemming from the position of the jawbones, this can deeply affect an individual’s physiological quality of life. The table below classifies the effects of skeletal jaw problems on daily life functions in light of medical data:

How Does the Orthognathic Surgery Planning Process Work at Opc Klinik in the Suadiye and Kadıköy Areas?

The planning process at Opc Klinik, located in the Suadiye and Kadıköy areas, begins with taking the patient’s detailed medical history, and continues with an interdisciplinary medical roadmap in which three-dimensional radiological imaging (tomography), intraoral digital scans, and cephalometric analyses are performed, with the millimeter-level movements of the jawbones predetermined in a virtual environment.

Preparation for orthognathic surgery is not carried out by a single physician but is a lengthy medical process jointly conducted by an orthodontist and a jaw surgeon. In light of the data obtained at the first examination, the patient’s current bone age and skeletal development are assessed. In the clinical setting in the Istanbul location, advanced digital scanners (intraoral scanners) are used instead of impression trays, transferring the patient’s oral cavity precisely into a computer environment. These digital models are combined with tomography data to perform “Virtual Surgical Planning.” Thanks to this technology, the direction and number of millimeters the bones will be moved is scientifically clarified before the operation, and surgical templates (guide splints) are produced.

Why Is Pre- and Post-Operative Orthodontic Treatment Applied in Orthognathic Surgery Processes?

Pre- and post-operative orthodontic treatment is necessary before the bones are moved in order to bring the teeth into their correct angles on their own jawbones (decompensation); after the operation, it is applied to ensure the upper and lower teeth achieve full, flawless engagement (occlusion) with each other based on the new jaw position.

Over the years, the teeth of individuals with a jaw disorder tilt to unnatural angles in order to adapt to (compensate for) the existing incorrect bone position. If surgery were performed directly while the teeth are at these tilted angles, the teeth would not fit together properly once the jawbones are brought into the correct position. To resolve this, the process proceeds through the following stages:

• Pre-Surgical Orthodontics (Preparation Stage): Using braces or clear aligners, the teeth are brought into their ideal anatomical inclination within the jawbone. Crowding in the teeth is corrected at this stage. The jaw disorder may become visually more pronounced during this stage; this is a natural part of the planning.
• Surgical Stage: Once the teeth are ready for surgery, the orthodontist communicates with the surgeon and the operation is planned. The surgery is performed with the braces still in the mouth.
• Post-Surgical Orthodontics (Refinement Stage): Beginning an average of 4-6 weeks after the operation, this period involves refining the contact between the teeth down to the millimeter in the new skeletal position and stabilizing the bite.

Which Medical Techniques (Osteotomies) Are Used in Lower and Upper Jaw Surgeries?

The medical techniques used in jaw surgeries are the Le Fort I osteotomy, in which the bone is horizontally freed for the upper jaw, and the Bilateral Sagittal Split Osteotomy (BSSO), planned lengthwise from the back of the jaw, for the lower jaw. Genioplasty techniques, which adjust the position of the chin tip, may also accompany these procedures when deemed necessary.

Surgical techniques vary depending on which jaw the problem is in, or whether there is involvement of both jaws (bimaxillary). All surgical incisions are made from inside the mouth, so no surgical scarring remains on the face, cheeks, or around the lips. The table below explains the surgical techniques applied and their physiological purposes:

Under What Conditions Are Istanbul Orthognathic Surgery Operations Performed?

The operations are performed, in accordance with medical regulations, in fully equipped general hospital settings that include an intensive care unit, under the control of specialist anesthesiologists, under general anesthesia, and in fully sterile operating room environments.

Orthognathic surgery is not a procedure that can be performed in clinic or office settings. In Opc Klinik’s processes, pre-operative preparations are carried out meticulously at the Suadiye and Kadıköy branches, while the surgical stage is performed in a hospital setting. Before the operation, the patient’s suitability for general anesthesia is assessed through detailed blood tests, an ECG (cardiogram), and a chest X-ray. The duration of the operation generally ranges from 2 to 5 hours, depending on whether only one jaw or both jaws are being treated. The jawbones, once brought into their new position, are fixed to the bone using body-compatible (titanium) mini plates and screws (rigid fixation). These materials remain within the bone, and their removal is generally not needed afterward.

How Does the Hospital Process and Early Healing Period Proceed After Jaw Surgery (Orthognathic Surgery)?

The early healing period begins with the patient being kept under observation in the hospital for an average of 1 to 3 days after the operation; during this time, fluid support is provided via IV, cold compresses are applied regularly to limit edema (swelling) in the area, and breathing and swallowing functions are closely monitored.

Swelling in the facial area occurs in the early post-operative period as a natural part of tissue healing. This is a physiological reaction. Patients must strictly follow medical guidelines during the healing process:

• Swelling Control: Applying an ice pack externally to the facial area during the first 48 hours is critical to stopping the increase in swelling. The period of most intense swelling is generally the 3rd or 4th day, after which it is gradually absorbed by the body and begins to decrease.
• Resting Position: Having the patient sleep with their head positioned higher than their body (using a double pillow) helps prevent blood pressure from accumulating in the head area, helping the swelling go down more quickly.
• Medical Treatment: Taking the antibiotics prescribed by the physician on schedule against the risk of infection and protecting the wound areas is mandatory. A feeling of tightness in the operated areas is a normal occurrence.
• Bleeding Control: Mild oozing-type bleeding from the wound lines inside the mouth or slight nosebleeds may be observed in the first few days. These situations are monitored under the supervision of nurses and physicians in the hospital setting.

What Stages Does the Post-Orthognathic Surgery Diet Consist Of?

The post-operative diet consists of a gradual process spanning several weeks, in which chewing is prohibited so as not to risk the healing of the jawbones, entirely liquid foods are consumed in the first weeks, followed by a transition to a puree consistency, and then to soft foods that do not require chewing.

The fusion of the newly fixed bones (osteosynthesis) requires a certain biological period. Not placing load on the bones during this time plays a key role in the success of the treatment. The medical nutrition protocol is generally managed as follows:

How Should Oral Hygiene Be Maintained After Jaw Surgery?

Oral hygiene should be maintained in the first days following the operation using special antimicrobial mouthwashes without bringing a brush into contact with the sutured areas, and after the period determined by the physician, thoroughly clearing the mouth of bacterial plaque using soft-tipped surgical brushes.

Hygiene rules are of vital importance to prevent infection of the surgical incision areas (sutures) inside the mouth. Since patients who have had jaw surgery experience tightness in the lips and cheeks due to swelling, opening the mouth fully is not possible in the first weeks. For this reason, small-headed children’s toothbrushes or post-operative brushes are used instead of standard brushing. Chlorhexidine-containing mouthwashes prescribed by the physician should be used regularly, morning and evening. Since the orthodontic wires are still in the mouth, food debris caught between the wires can create a risk of infection; for this reason, the gentle use of interdental brushes is incorporated into the process once the soft-diet stage is reached.

What Are the Possible Situations and Risk Factors That May Be Encountered in Orthognathic Surgery?

The possible situations that may be encountered are medical factors that are part of the anatomical healing process, such as temporary loss of sensation (numbness) in the lower lip and chin that can last for months, noticeable swelling in the facial area, restricted joint movement, and nasal congestion following interventions close to the sinus cavities.

As with any major surgical operation, physiological reactions develop in orthognathic surgery as well. In lower jaw operations, temporary numbness in the lip and chin, resulting from the movement or stretching of the nerve running through the bone (Inferior Alveolar Nerve), is a frequently encountered situation. This numbness does not affect motor functions (lip movement); it only involves a decrease in the sense of touch. Since nerve tissue is the slowest-regenerating tissue in the human body, this sensation may take weeks or months to fully return. In Opc Klinik’s processes, the use of surgical templates and three-dimensional planning ensures that high-level precautions are taken to protect the nerve line. In addition, difficulty fully opening the mouth (trismus) may be seen after the operation due to tension in the jaw muscles; this is overcome over time with the jaw exercises the physician will recommend.

What Are the Long-Term Follow-Up Processes Offered by Istanbul Opc Klinik?

The long-term follow-up processes consist of the patient being assessed by orthodontics and jaw surgery specialists at the clinics in the Suadiye and Kadıköy areas through periodic radiological examinations after surgery, monitoring of bone fusion, and the removal of the orthodontic wires followed by the application of retention (stabilization) plates.

Orthognathic surgery is not a treatment that ends on the day of the operation, but a medical journey that requires meticulous follow-up afterward as well. Check-ups at the first week, 1st month, 3rd month, and 6th month after discharge are standard procedures. Panoramic X-rays or tomography scans taken during these check-ups are used to examine the condition of the titanium plates and the density of bone-cell fusion. Orthodontic treatment continuing after the surgical procedure (the process of settling the bite) can generally take another 4 to 8 months. Once the wires are removed, a fixed retainer (protective wire) is bonded to the back surfaces of the teeth to prevent the teeth from tending to return to their old positions (relapse), and clear retainer trays are given to the patient.

How Do Speech and Breathing Functions Change After Surgery?

Breathing and speech functions improve, as the jawbones are brought into their correct positions, allowing for easier breathing thanks to the widening of the airway (air passage), while the tongue finding its ideal position within the mouth provides a noticeable physiological improvement in the pronunciation of certain letters.

Particularly in patients whose lower jaw is set back (retrognathic), the base of the tongue narrows the airway, leading to snoring and sleep apnea. By bringing the lower jaw forward, the airway volume behind the base of the tongue expands, and the individual begins to receive more oxygen during sleep. In cases with a forward-set lower jaw (prognathic) or an open bite, difficulty is experienced in pronouncing letters such as s, z, and t, since the tongue slips between the teeth. Correcting the bite allows the lips to close comfortably and the tongue to contact the correct point on the palate, restoring phonetic (speech-sound) ability to its natural anatomical limits. During this process, patients are advised to perform physiological exercises such as reading aloud to help the tongue adapt to the new jaw position.

Is There an Ideal Age Limit for Orthognathic Surgery (Jaw Surgery)?

The ideal age limit — since it is a medical rule that orthognathic surgery be performed after skeletal growth and development have been completed — generally covers the period after age 18-19 in women, and after age 20-21 in men, since bone development is completed somewhat later in men.

If the operation is performed while jaw growth is still ongoing, the bones may continue to grow after surgery according to their own genetic growth potential, and the anatomical correction achieved through surgery could be disrupted. For this reason, in the diagnostic processes at the Suadiye and Kadıköy locations of Opc Klinik, hand-wrist X-rays (bone-age determination) or successive cephalometric X-ray measurements are performed on young patients to confirm that their growth spurts have stopped. As for the upper age limit, treatment can also be applied at more advanced ages, as long as the patient does not have a severe systemic disease that would prevent them from undergoing general anesthesia (such as uncontrolled heart failure) and their bone-healing potential is sufficient.

The correct answer is to see a temporomandibular joint (TMJ) specialist. Doctors specializing in this area may come from different medical or dental disciplines and manage different aspects of treatment. However, the doctor who will diagnose jaw pain and dysfunction is either an oral and maxillofacial surgeon or a prosthetic dentistry specialist (prosthodontist) experienced in TMJ issues. Ideally, both specialists should examine you together.

How is a Temporomandibular Joint Examination Performed Step-by-Step?

During the initial examination, we ask the patient detailed questions: the onset of symptoms, the severity of pain, and the extent of jaw function loss are assessed. Then, mouth opening is measured; this data is crucial for both accurate diagnosis and monitoring the treatment process.

Next, a physical examination of the chewing muscles and temporomandibular joint is performed:

• Painful areas are identified,
• The function in which the pain intensifies is determined,
• It is checked whether jaw movements are within normal limits.

After this information is recorded, a detailed examination of the teeth is performed. Because pathologies that may occur in the teeth are close enough to be reflected in this area. Also, the main result of the chewing system is to bring the teeth together; therefore, a detailed analysis of the overlapping relationship of the teeth, which we call dental occlusion, is extremely important. This is why the treatment of the temporomandibular joint and muscles is managed by specialist dentists.

Imaging Methods in Jaw Pain: Jaw MRI and CT Scan

As a final step, MRI (magnetic resonance imaging) or CT scan is requested when necessary. MRI is the only way to image the temporomandibular joint disc. The disc, which acts like a cushion between the upper and lower jaw and enables jaw movements during function, is directly affected in temporomandibular joint (TMJ) disorders, and MRI imaging is the way to see this disc in detail.

If the solution to the intra-articular pathology is interventional (such as joint surgery, intra-articular lavage/arthrocentesis), MRI imaging may be requested.

The ideal TMJ treatment process involves the joint management of the process by an oral surgeon and a prosthetic dentist. In some cases, physical therapy support may be necessary.

AUTOR
Uzm. Dt. Reşat Batuhan ÇETİNER

Prosthodontics and Aesthetic Dentistry

Dr. Resat Batuhan Cetiner graduated from the Faculty of Dentistry at Baskent University. He completed his specialization in Prosthodontics at Ondokuz Mayis University and continues his academic career as a faculty member at Istanbul Aydin University.

Specializing in digital dentistry, aesthetic smile design, and temporomandibular joint (TMJ) treatments, Dr. Cetiner focuses on providing functional, aesthetic, and patient-centered treatment solutions by combining contemporary clinical approaches with advanced digital technologies.

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Although the term “night guard” is very commonly used in society, it is not actually a completely accurate definition. This is because every appliance used overnight is popularly called a night guard. However, there are appliances used for different purposes and with quite different characteristics from each other.

Therefore, it is necessary to first know which appliance is used for what purpose.

Not every night guard is the same

There are two different appliance treatments we apply most frequently in our clinic:

• Teeth clenching guard (protective guard)
• Occlusal splint (therapeutic splint)

Although the appearance of these two appliances is similar, their purpose of use and effects are completely different.

What does a teeth clenching guard do?

A teeth clenching guard is a hard and transparent appliance, generally 1-2 mm thick.

Its primary purpose is to reduce the damaging effects of nighttime teeth clenching and grinding on teeth, implants, laminates, crowns, and other restorations.

It is a protective treatment. It protects the teeth against wear but is not used alone to treat jaw joint diseases.

What is an occlusal splint?

If there are complaints in the jaw joint such as;

• pain,
• restriction in opening the mouth,
• joint sounds,
• discomfort during chewing

thin protective guards are often not sufficient.

In this case, the appliance we most frequently prefer for treatment purposes is the occlusal splint.

Occlusal splints are generally 4-6 mm thick, made of hard material, and the points where the teeth contact each other are customized specifically for the patient.

Its purpose in treatment is not only to protect the teeth. At the same time, it aims to:

• help relax the chewing muscles,
• reduce the load on the jaw joint,
• ensure the relief of the disc and surrounding tissues,
• contribute to the reduction of pain and loss of function.

How is an occlusal splint prepared?

The treatment process begins with a detailed examination.

In the first appointment, the jaw joint, chewing muscles, mouth opening, and jaw movements are evaluated. Splint treatment is not applied to every patient. If it is decided as a result of the examination that it is a suitable option for you, the impression stage begins.

In our clinic, impressions are taken with a digital intraoral scanner. Thus, a three-dimensional model of the teeth and jaws is obtained without the need for traditional impression materials.

The appliance is planned by the physician using these digital records and is generally prepared within 1-2 days.

In the second appointment, the most important stage, which is the adjustment process, is performed.

Even if the appliance is produced digitally, it is absolutely checked in detail inside the mouth. Contact points for each tooth are adjusted one by one, jaw movements are evaluated, and after the necessary corrections are made, the appliance is polished and delivered.

This stage is one of the most important steps that directly affects the success of the treatment.

How many hours a day should a night guard be used?

The duration of splint use can vary depending on the patient’s diagnosis and complaints.

In general, it is sufficient to use occlusal splints for 10-12 hours a day.

Our first preference is definitely for the appliance to be worn at night. This is because parafunctional habits such as teeth clenching and grinding mostly occur during sleep, and the person does not notice them. Therefore, the appliance shows its protective and therapeutic effects most during nighttime use.

For our patients who sleep less than 7-8 hours a night, I recommend an additional 3-4 hours of use during the day.

How long is a night guard used?

The treatment duration is not the same for every patient.

The duration can vary depending on the cause of the complaint, the condition of the jaw joint, and the response to the treatment. However, in most patients, splint treatment continues for approximately 6 months.

During this process, the appliance must be checked regularly. Usually, with 3-4 control appointments, contact points are re-evaluated, and minor adjustments are made if necessary.

Conclusion

A night guard does not serve the same purpose for every patient. Thin guards used only to protect the teeth and occlusal splints used in the treatment of jaw joint disorders are different from each other.

Therefore, if you have complaints such as jaw pain, restriction in opening the mouth, or joint sounds, an accurate diagnosis must first be made instead of using a ready-made night guard. A correctly planned splint treatment in the right patient can significantly contribute to both the reduction of pain and the improvement of jaw joint functions.

AUTOR
Uzm. Dt. Reşat Batuhan ÇETİNER

Prosthodontics and Aesthetic Dentistry

Dr. Resat Batuhan Cetiner graduated from the Faculty of Dentistry at Baskent University. He completed his specialization in Prosthodontics at Ondokuz Mayis University and continues his academic career as a faculty member at Istanbul Aydin University.

Specializing in digital dentistry, aesthetic smile design, and temporomandibular joint (TMJ) treatments, Dr. Cetiner focuses on providing functional, aesthetic, and patient-centered treatment solutions by combining contemporary clinical approaches with advanced digital technologies.

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It is quite common to hear a clicking, pop, or grating sound when opening and closing your jaw. The most common cause of these sounds is disc displacement with reduction, which occurs when the disc in the jaw joint slips out of its normal position.

The disc in the jaw joint is a structure that ensures the joint functions smoothly and in a balanced manner during the movements of the lower jaw. In the case of disc displacement, a characteristic clicking sound occurs as the disc snaps back into place when the mouth is opened or closed.

If the sound comes from only one side, a slight deviation of the lower jaw to that side while opening the mouth is also a common finding.

Should you be concerned if your jaw joint makes sounds?

Not every jaw sound indicates a serious problem. However, this situation should not be ignored.

Disc displacement with reduction is a common disorder in the society. Nevertheless, it is important to be evaluated by a dentist experienced in temporomandibular joint diseases.

If the disc continues to function in the wrong position for a long time, structural changes can develop over time. In the later stages, deformation of the disc may occur, or the disc may become displaced in such a way that it can no longer return to its original position.

At this point, a situation arises that surprises many patients: The clicking sound may disappear. However, the disappearance of the sound does not always mean healing. On the contrary, during this period, restricted mouth opening, a feeling of locking in the jaw, and difficulty during chewing may be observed.

What other sounds can be heard besides clicking?

Another sound described by our patients is a grating sound similar to walking on snow (crepitus).

This sound is usually seen in advanced ages and is mostly associated with degenerative changes in the jaw joint, especially osteoarthritis.

The evaluation of crepitus is important in terms of understanding the structural changes occurring in the joint.

Is there a treatment for jaw sounds?

Sound coming from the jaw joint is not a condition we aim to treat on its own.

The main factors determining the treatment decision are;

• pain in the jaw joint,
• restricted mouth opening,
• deterioration in chewing function,
• loss of function affecting daily life.

If these findings accompany the sound, treatment should be initiated.

The role of the stabilization splint in jaw joint treatment

In patients with pain and restricted mouth opening, a stabilization splint is one of the first-line treatments, along with physical therapy applications and, when necessary, medication.

When accurately diagnosed and used in suitable patients, it can contribute to a reduction in pain, improvement in jaw functions, and the complete disappearance or significant reduction of joint sounds in many cases.

However, the primary goal of treatment is not to completely eliminate the sound. The main purpose is to control the pain, restore jaw functions, and prevent the progression of the disease in the joint.

If your jaw has been making sounds for a long time, and this is accompanied by pain or restricted mouth opening, the most appropriate approach would be to consult a dentist experienced in temporomandibular joint diseases without wasting time.

AUTOR
Uzm. Dt. Reşat Batuhan ÇETİNER

Prosthodontics and Aesthetic Dentistry

Dr. Resat Batuhan Cetiner graduated from the Faculty of Dentistry at Baskent University. He completed his specialization in Prosthodontics at Ondokuz Mayis University and continues his academic career as a faculty member at Istanbul Aydin University.

Specializing in digital dentistry, aesthetic smile design, and temporomandibular joint (TMJ) treatments, Dr. Cetiner focuses on providing functional, aesthetic, and patient-centered treatment solutions by combining contemporary clinical approaches with advanced digital technologies.

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Known as jaw botox, masseter botox is a method used in the treatment of bruxism (teeth grinding), masseter hypertrophy (a swollen appearance due to the enlargement of muscles at the corners of the jaw), and muscle-related masticatory system disorders.

However, it is not a suitable treatment for every patient who grinds their teeth or experiences jaw pain. Therefore, a detailed evaluation of the temporomandibular joint and masticatory muscles is required before the application.

How does masseter botox work?

The masseter muscle is one of the primary muscles that provides chewing function, but it is not the only one.

Another important muscle involved in the masticatory system is the temporal muscle, which extends in a fan shape in the temple area. Especially in temporomandibular disorders (masticatory system disorders) accompanied by headaches, botulinum toxin application to the temporal muscle can also contribute to the treatment in suitable patients.

In which situations is jaw botox applied?

Masseter botox may not be the appropriate treatment option for every jaw muscle pain or teeth grinding problem.

First of all, the effect of botox is temporary and generally needs to be repeated approximately every 6 months.

In addition, botulinum toxin cannot be applied to all masticatory muscles. For example, the lateral pterygoid and medial pterygoid muscles are not suitable for injection due to their anatomical locations, or their applications are quite difficult. In patients where the source of pain is thought to be these muscles, masseter botox alone will not provide sufficient benefit.

Besides this, the regular application of masseter botox in individuals with a long facial structure and an unpronounced masseter muscle can negatively affect facial aesthetics and cause a sagging appearance due to volume loss in the lower face and neck region.

Therefore, the treatment decision must be made by evaluating the patient’s facial structure, muscle volume, and complaints together.

To which patients do we apply jaw botox?

In our clinic, we most frequently prefer masseter botox for patients with masseter hypertrophy accompanied by teeth grinding or jaw pain.

In these patients, it helps both to reduce the severity of teeth grinding and can provide a slimmer facial contour as the muscle volume at the corners of the jaw decreases over time.

Furthermore, in patients who have intense teeth grinding and cannot use or tolerate a night guard, it can be evaluated among the treatment options by making an appropriate case selection.

Which doctor should perform jaw botox?

Unlike the mimetic muscles of the face, masticatory muscles are functional muscles. Injections to these muscles can affect not only the aesthetic appearance but also the way the masticatory system works.

Therefore, it is important that masseter botox is applied by dentists who have received training in temporomandibular joint diseases and the masticatory system.

Particularly, Oral and Maxillofacial Surgery and Prosthodontics specialists receive comprehensive training in the diagnosis and treatment of masticatory system diseases during their education.

How much does jaw botox cost?

The price of jaw botox may vary depending on the number of areas to be treated, the amount of botulinum toxin to be used, and the treatment plan.

According to the 2026 Turkish Dental Association Minimum Wage Tariff, the fee for “Botulinum Toxin Application in Dentistry” is set at 10,500 TL.

The exact treatment plan and the dose to be administered are determined according to the patient’s needs after the examination.

AUTOR
Uzm. Dt. Reşat Batuhan ÇETİNER

Prosthodontics and Aesthetic Dentistry

Dr. Resat Batuhan Cetiner graduated from the Faculty of Dentistry at Baskent University. He completed his specialization in Prosthodontics at Ondokuz Mayis University and continues his academic career as a faculty member at Istanbul Aydin University.

Specializing in digital dentistry, aesthetic smile design, and temporomandibular joint (TMJ) treatments, Dr. Cetiner focuses on providing functional, aesthetic, and patient-centered treatment solutions by combining contemporary clinical approaches with advanced digital technologies.

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Pain and functional losses in the jaw muscles and jaw joint are generally referred to as chewing system diseases or, in medical terms, temporomandibular disorders (TMD).

What Are the Symptoms of Temporomandibular Disorders (TMD)?

Jaw joint disorders frequently manifest in our patients with the following symptoms:

• Significant pain in the jaw and chewing muscles,
• Restricted mouth opening (inability to fully open the mouth),
• Pain, clicking, or locking sensation during mouth opening and closing.

Which Specialist Should Be Consulted for Jaw Pain?

The specialized physicians to consult for these and similar complaints are: Oral and Maxillofacial Surgeons, Prosthetic Dentistry Specialists (Prosthodontists), and Orthodontists are specialists in this field.

Dentists specializing in temporomandibular joint disorders work in full collaboration with Physical Medicine and Rehabilitation (PMR) specialists, Neurology specialists, and physiotherapists during the diagnosis and treatment process if deemed necessary.

Patients experiencing jaw pain and joint problems should consult multidisciplinary dental clinics that house these specialties, eliminating the risk of wasting time due to incorrect referrals.

The Relationship Between Jaw Pain and Ear Pain

Jaw pain is often confused with ear pain. The temporomandibular joint (TMJ) is anatomically located very close to the external auditory canal. Joint pain in this area may be mistaken for ear pain by the patient, and they may initially consult an Ear, Nose, and Throat (ENT) specialist. In such a case, the ENT specialist will determine that there is no problem with your ear and will refer you to a competent maxillofacial surgery or temporomandibular joint (TMJ) center.

Why are Jaw Pain Treatments Performed by Dentists?

The jaws are integral parts of the chewing system due to the teeth they carry and the functions they perform. The contact and relationship between the teeth (occlusion) is the fundamental purpose of this system. Conditions affecting the chewing muscles and the temporomandibular joint are either a result of this occlusion or directly affect it. Therefore, the primary field for examination and treatment of jaw pain is dentistry.

The field of maxillofacial surgery (internationally known as Oral and Maxillofacial Surgery) is the specialty branch of dentistry that undertakes surgical interventions targeting the jaw and facial complex. Therefore, oral surgeons (dentists) possess deep expertise in the differential diagnosis of jaw pain.

Furthermore, jaw pain is not only joint-related; it can also stem from conditions such as:

Dental infections,

Impacted teeth,

Jaw cysts and tumors.

Since all these conditions fall directly within the treatment area of ​​oral surgeons, jaw pain is historically and medically a central topic in the discipline of dentistry. Assoc. Prof. Dr. Ezgi Yüceer Çetiner

AUTOR
Doç. Dr. Ezgi Yüceer Çetiner

Oral, Dental and Maxillofacial Surgery

Assoc. Prof. Dr. Ezgi Yüceer Çetiner graduated from Başkent University Faculty of Dentistry. She completed her specialization training in Oral, Dental and Maxillofacial Surgery at Ondokuz Mayıs University and continues her academic career as a faculty member at Bahçeşehir University Faculty of Dentistry. She also holds a master’s degree in Tissue Engineering and Regenerative Medicine.

Specializing in the treatment of dental implant surgery, bone augmentation procedures (alveolar reconstruction), temporomandibular joint (TMJ) disorders, and jaw cysts/tumors, Assoc. Prof. Dr. Yüceer Çetiner focuses on providing functional, reliable, and patient-centered treatment solutions by combining her academic knowledge with current surgical approaches.

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