What is orthognathic surgery?

Orthognathic surgery is also known as corrective jaw surgery. 
It is used to treat a variety of facial and jaw abnormalities in which the facial bones and teeth are not correctly developed. 

 

This results in difficulty with chewing, speech, and jaw function. In many cases, the facial appearance is affected by this problem. Orthognathic means "straight jaws", and orthognathic surgery corrects these jaw and facial deformities, usually in conjunction with an orthodontist, so that after the jaws are corrected, the teeth will come together properly.

 

Orthognathic surgery is needed when jaws don't meet correctly and/or teeth don't seem to fit with jaws. Teeth are straightened with orthodontics and corrective jaw surgery repositions misaligned jaws.  This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

 

Who Needs Orthognathic Surgery? People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly.

 

Jaw growth is a gradual process and, in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance.

 

Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required when the jaws need repositioning.

Orthognathic Surgery

What areas of difficulty should be evaluated?
 
  • Difficulty in chewing, biting or swallowing
  • Speech problems
  • Chronic jaw or TMJ pain
  • Open bite
  • Protruding jaw
  • Breathing problems
 

Any of these can exist at birth or may be acquired after birth as a result of hereditary or environmental influences or the result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. 

 

During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team will make the decision to proceed with treatment together.

 

Sometimes, braces alone can correct a problem with the bite, but when it is severe, usually orthognathic surgery is required. 

 

Abnormal jaw and facial development can be genetic or acquired due to disease or injury.  When the jaws are not properly developed or proportioned, problems such as difficulty chewing, jaw and facial pain, speech abnormalities and dental problems can result. 

 

Using sophisticated surgical techniques, the facial bones can be repositioned in order to restore proper function and facial appearance.

                                               

In the past, thin wires were used to support the bones in the new positions, but because this was not stable, the patient also had to endure periods of 6 to 12 weeks of "intermaxillary fixation," or having their teeth and jaws wired together. Not only was this uncomfortable, but oral hygiene was difficult and post-operative weight loss was a problem.

In the past, thin wires were used to support the bones in the new positions, but because this was not stable, the patient also had to endure periods of 6 to 12 weeks of "intermaxillary fixation," or having their teeth and jaws wired together. Not only was this uncomfortable,  but oral hygiene was difficult and post-operative weight loss was a problem.

Today, miniature titanium plates and screws are used to fixate the facial bones in their new relationship. This is much more comfortable for the patient, but it is also more stable and predictable. 

This, in combination with new instruments and anesthetic techniques, has allowed orthognathic surgery to be safer and more effective, and is much easier for the patient to undergo. 
 

New advances in orthodontics have also allowed the total treatment times to be shortened. A surgery first approach can be used to utilize your body's enhanced healing after surgery to rapidly move the teeth.  The procedure can also be performed in conjunction with Invisalign therapy in select cases. 

 

In addition, some patients may decide to have other cosmetic procedures done in conjunction with orthognathic surgery to further enhance their facial appearance. These include procedures to the chin, jawline, cheeks, eyes, nose, neck and facial skin.

Sometimes, the problem is in both the upper and lower jaws. Here, the upper jaw is brought down and forwards, and the lower jaw is moved back. A combination of plates and screws stabilize the surgical result

If the upper jaw is in normal position, but the lower jaw is retruded, the lower jaw is brought forward to its proper position. Small screws hold the bones in their new positions. 

Orthognathic surgery is performed in the hospital or outpatient surgical center. Patients generally stay in the hospital 1-2 nights, depending on the extent of surgery done. 


Most patients state that the post-operative discomfort is much less than they were expecting. Almost all patients agree that they are happy with the results and would go through the surgery again, without hesitation. 

 

The improvement in jaw function and facial appearance is remarkable. Most patients experience a great improvement in their self-confidence and quality of life after orthognathic surgery.