“Can screws come loose after jaw surgery?”
I am a 28 year old male and I will have jaw surgery. Can screws come loose after jaw surgery?
7 Answers
It's uncommon...but it can happen, particularly with thin bone.
Yes and sometimes they have to be removed. Once you are past the 8-12 weeks of bony healing they serve no purpose.
That would be a rare complication.
Yes, sometimes the screw can come lose, it can easily be removed under local anesthesia., not a major surgery or issue.
Yes.
Matthew Bronk
Oral and Maxillofacial Surgeon | Oral and Maxillofacial Surgery
Marion, North Carolina
Good Morning,
As a surgeon who has performed hundreds of orthognathic surgeries, I can tell you that it's unlikely for a screw to come loose, but is always a possibility. This is true moreso in the maxilla (top jaw) following a LeFort. This is because the screws used in a maxillary surgery are smaller, the bones are thinner and the bone quality is less dense. If you are truly compliant and eat a soft, non-chew diet for at least 6 weeks, then it is far less likely as well. If one of the screws does come loose, say 6 months later, a year later, 2 years later, it can usually be removed with IV sedation in the office setting, and the bones are usually healed enough by then that no additional surgery is needed. In mandibular surgery (bottom jaw), I usually will utilize bicortical screws that are quite a bit longer. Bicortical means that they engage both sides of the mandible where the bone is VERY hard. Over many years of doing
these cases, I have yet to see a mandibular screw work it's way out. I'm sure it has happened in the long history (about 70 years) of this procedure (BSSO), but it's extremely rare. Again, you must still follow the NON-CHEW diet protocol for 6 weeks following your surgery. Usually, my patients are very compliant for the first 2-3 weeks ( I do short weekly follow-ups for 6 weeks after surgery). Then they will ask the following question: "Do I REALLY need to not chew for 3-4 more weeks?" YES!!! This is the difficult timeframe because the patient is feeling much better and really feels that it will be okay to chew. This is simply not true. I had one patient that did have hardware that had loosened on the maxilla and it was about weeks 4 post-op. When I asked if he'd been chewing, he admitted that he'd had a hamburger, the weekend after the 3-week follow-up. I also saw that he had brought in a motorcycle helmet. I asked him what he rode and he told me a that it was a Harley Davidson. Since his maxilla was "loose," I said, no more chewing, SOFT BLENDED, NON-CHEW diet ONLY and NO HARLEY for the next 6 weeks! Wouldn't you know it, he came back 2 weeks later and the jaw had tightened up. This was a close call as we almost had to return to the OR to re-fixate him (new plates and screws). Fortunately, that wasn't required. I now tell all of my patients that in addition to 6 weeks of soft, non-chew diet, no motorcycle riding or anything similar that might cause jarring/vibration of the maxilla. See there, even crusty old surgeons can learn a few things.
I hope this answer helps you out. Good luck with your surgery and remember to keep hydrated afterwards and use a soft, blenderized diet. There are lots of good things that you can blend and still taste suprisingly well.
Dr. Matt Bronk
As a surgeon who has performed hundreds of orthognathic surgeries, I can tell you that it's unlikely for a screw to come loose, but is always a possibility. This is true moreso in the maxilla (top jaw) following a LeFort. This is because the screws used in a maxillary surgery are smaller, the bones are thinner and the bone quality is less dense. If you are truly compliant and eat a soft, non-chew diet for at least 6 weeks, then it is far less likely as well. If one of the screws does come loose, say 6 months later, a year later, 2 years later, it can usually be removed with IV sedation in the office setting, and the bones are usually healed enough by then that no additional surgery is needed. In mandibular surgery (bottom jaw), I usually will utilize bicortical screws that are quite a bit longer. Bicortical means that they engage both sides of the mandible where the bone is VERY hard. Over many years of doing
these cases, I have yet to see a mandibular screw work it's way out. I'm sure it has happened in the long history (about 70 years) of this procedure (BSSO), but it's extremely rare. Again, you must still follow the NON-CHEW diet protocol for 6 weeks following your surgery. Usually, my patients are very compliant for the first 2-3 weeks ( I do short weekly follow-ups for 6 weeks after surgery). Then they will ask the following question: "Do I REALLY need to not chew for 3-4 more weeks?" YES!!! This is the difficult timeframe because the patient is feeling much better and really feels that it will be okay to chew. This is simply not true. I had one patient that did have hardware that had loosened on the maxilla and it was about weeks 4 post-op. When I asked if he'd been chewing, he admitted that he'd had a hamburger, the weekend after the 3-week follow-up. I also saw that he had brought in a motorcycle helmet. I asked him what he rode and he told me a that it was a Harley Davidson. Since his maxilla was "loose," I said, no more chewing, SOFT BLENDED, NON-CHEW diet ONLY and NO HARLEY for the next 6 weeks! Wouldn't you know it, he came back 2 weeks later and the jaw had tightened up. This was a close call as we almost had to return to the OR to re-fixate him (new plates and screws). Fortunately, that wasn't required. I now tell all of my patients that in addition to 6 weeks of soft, non-chew diet, no motorcycle riding or anything similar that might cause jarring/vibration of the maxilla. See there, even crusty old surgeons can learn a few things.
I hope this answer helps you out. Good luck with your surgery and remember to keep hydrated afterwards and use a soft, blenderized diet. There are lots of good things that you can blend and still taste suprisingly well.
Dr. Matt Bronk
Yes, in a small number of cases, the titanium screws placed during surgery to hold the jaw bones in place can come loose and require removal. Generally, removal is a simple procedure and can sometimes be completed under local anesthesia in the office. If they come loose, they will need to be removed.
