The maxilla is the bone that forms your upper jaw. The right and left halves of the maxilla are irregularly shaped bones that fuse together in the middle of the skull, below the nose, in an area known as the intermaxillary suture.
The maxilla is a major bone of the face. It’s also part of the following structures of your skull:
- the upper jawbone, which includes the hard palate at the front of your mouth
- the lower part of your eye sockets
- the lower parts and sides of your sinus and nasal cavities
The maxilla is also fused together with other important bones in the skull, including:
- the frontal bone, which makes contact with bones in the nose
- the zygomatic bones, or cheek bones
- the palatine bones, which make up part of the hard palate
- the nasal bone, which makes up the bridge of your nose
- the bones that hold your dental alveoli, or tooth sockets
- the bony part of your nasal septum
The maxilla has several main functions, including:
- holding the top teeth in place
- making the skull less heavy
- increasing the volume and depth of your voice
The maxilla is part of an area of your skull called the viscerocranium. Think of it as the facial part of your skull. The viscerocranium contains bones and muscles that take part in many important bodily functions, such as chewing, speaking, and breathing. This area contains many important nerves and shields the eyes, brain, and other organs during facial injuries.
Many facial muscles are connected to the maxilla on both its inner and outer surfaces. These muscles allow you to chew, smile, frown, make faces, and do other important functions. Some of these muscles include:
- buccinator: a cheek muscle that helps you whistle, smile, and keep food positioned in your mouth when you chew
- zygomaticus: another cheek muscle that helps raise the edges of your mouth when you smile; in some cases, dimples form on the skin above it
- masseter: an important muscle that aids in chewing by opening and closing your jaw
A maxilla fracture happens when the maxilla becomes cracked or broken. This often happens due to injuries to the face, such as from falling, a car accident, getting punched, or running into an object. These injuries can be significant.
Maxilla fractures and other fractures that occur to the front of the face are also known as mid-face fractures. These can be categorized using a system called Le Fort classification:
- Le Fort I: The fracture occurs in a line above and across the upper lip, separating the teeth from the maxilla, and involving the lower portion of the nasal passages.
- Le Fort II: This is a triangular-shaped fracture that involves the teeth at the base and the bridge of the nose at its upper point, as well as the eye sockets and nasal bones.
- Le Fort III: The fracture occurs across the bridge of the nose, through the eye sockets, and out toward the side of the face. This is the most severe type of facial fracture, often resulting from major trauma to the face.
Possible symptoms of a maxilla fracture can include:
- bruising around your eyes and nose
- cheek swelling
- misaligned jaw
- irregular shaping around your nose
- vision difficulties
- seeing double
- numbness around your upper jaw
- having trouble chewing, speaking, or eating
- pain in your upper lip and jaw when you chew, speak, or eat
- loose teeth or teeth falling out
Possible complications of an untreated maxilla fracture can include:
- losing the ability to chew, speak, or eat normally
- permanent numbness, weakness, or pain in your jaw
- having trouble smelling or tasting
- having trouble breathing through your nose
- brain or nerve damage from trauma to the head
A maxilla surgery may be done if your maxilla or the surrounding bones are fractured, broken, or injured in some way.
Your doctor may recommend alternatives if the fracture isn’t serious enough to require surgery and will heal on its own. In this case, you may need to simply eat soft foods to allow your jaw to heal and see your doctor frequently for check-ups to monitor the maxilla’s healing.
If your doctor does recommend surgery for a fractured maxilla and other bones, your procedure will typically consist of the following steps:
- Receive preliminary blood and health tests, including a physical examination. You will need X-rays, CT scans, and/or MRIs. You will also need to sign a consent form.
- Arrive at the hospital and be admitted. Make sure you’ve planned for time off according to your doctor’s recommendations.
- Change into a hospital gown. You will wait in the preoperative area and meet with the surgeon and the anesthesiologist before going into surgery. You will be hooked up to an intravenous (IV) line. In the operating room, you will receive general anesthesia.
Depending on the severity of your injuries, a wide range of surgical repair may be required. Your doctors will describe in detail the type of surgery you need, the procedures involved, recovery time, and follow-up. The extent of injuries, type of surgery, and other medical complications determine how long you stay in the hospital after surgery.
Depending on the extent of injury to your face, head, mouth, teeth, eyes, or nose, you may need a variety of specialists including, eye surgeons, oral surgeons, neurosurgeons, plastic surgeons, or ENT (ear, nose, throat) surgeons.
Surgery can last many hours depending on how severe the fractures are. You may also need to have multiple surgeries depending on your injuries.
Bones take a long time to heal. Depending on your injuries, it may take two to four months or more. Your doctor will determine when and how frequently they want to see you after surgery and once you are home.
During the healing process, do the following to make sure your jaw heals well:
- Follow any meal plan your doctor gives you to ensure your jaw doesn’t get strained by chewing hard or tough foods.
- Follow specific instructions about activity.
- Follow specific instructions about wound care and promoting healing, including when to return for checkups.
- Take any antibiotics or medications your doctor prescribes for pain and infections.
- Don’t go back to work, school, or other normal responsibilities until your doctor says it’s okay.
- Don’t do any intense exercise.
- Don’t smoke and limit alcohol intake.
Your maxilla is a crucial bone in your skull’s structure and enables many basic functions, such as chewing and smiling. If it’s fractured, it can affect many other important bones around it and keep you from accomplishing even simple daily tasks.
Maxilla surgery is a safe procedure with a high success rate. If you experience any trauma to your face or head, see your doctor right away. Getting an evaluation of any injuries early on is important for proper healing. Following all your doctor’s instructions for treating any fractures of the maxilla is the best way to ensure a positive outcome.